Healthcare Provider Details

I. General information

NPI: 1740883859
Provider Name (Legal Business Name): ABIGAIL BEAUMONT GABRIEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 NW 57TH ST
GAINESVILLE FL
32605-4482
US

IV. Provider business mailing address

1034 NW 57TH ST
GAINESVILLE FL
32605-4482
US

V. Phone/Fax

Practice location:
  • Phone: 352-519-5430
  • Fax:
Mailing address:
  • Phone: 352-519-5430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11009404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: