Healthcare Provider Details

I. General information

NPI: 1154339398
Provider Name (Legal Business Name): GABLES CT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 SW 99TH AVE STE 106
MIAMI FL
33173-4661
US

IV. Provider business mailing address

7101 SW 99TH AVE STE 106
MIAMI FL
33173-4661
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-9992
  • Fax: 305-596-0942
Mailing address:
  • Phone: 305-596-9992
  • Fax: 305-596-0942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUAN FERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-596-9992