Healthcare Provider Details

I. General information

NPI: 1578256913
Provider Name (Legal Business Name): GABRIELA URATSUKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 SW 126TH PL
MIAMI FL
33184-2310
US

IV. Provider business mailing address

1420 SW 126TH PL
MIAMI FL
33184-2310
US

V. Phone/Fax

Practice location:
  • Phone: 786-370-1156
  • Fax:
Mailing address:
  • Phone: 786-370-1156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11026381
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11026381
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: