Healthcare Provider Details

I. General information

NPI: 1427251206
Provider Name (Legal Business Name): COLETTE GIBBS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18055 SW 12TH ST
MIAMI FL
33194-2715
US

IV. Provider business mailing address

7701 SW 136TH AVE
MIAMI FL
33183-3210
US

V. Phone/Fax

Practice location:
  • Phone: 305-222-5000
  • Fax:
Mailing address:
  • Phone: 305-388-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number1534422
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1534422
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1534422
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1534422
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1534422
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: