Healthcare Provider Details
I. General information
NPI: 1609466648
Provider Name (Legal Business Name): GNS MEDICAL SERVICES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2021
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11880 SW 40TH ST STE 305
MIAMI FL
33175-3574
US
IV. Provider business mailing address
4661 SW 153RD CT
MIAMI FL
33185-5225
US
V. Phone/Fax
- Phone: 305-223-3131
- Fax:
- Phone: 786-554-1055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGES
SALIBA
Title or Position: OWNER
Credential: MD
Phone: 786-554-1055