Healthcare Provider Details

I. General information

NPI: 1205516721
Provider Name (Legal Business Name): GML MEDICAL SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8494 SW 8TH ST
MIAMI FL
33144-4153
US

IV. Provider business mailing address

2663 W 69TH TER
HIALEAH FL
33016-5486
US

V. Phone/Fax

Practice location:
  • Phone: 305-846-9007
  • Fax:
Mailing address:
  • Phone: 786-564-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GISNY D MARTIN LOPEZ
Title or Position: PRESIDENT
Credential: NP
Phone: 786-564-4791