Healthcare Provider Details

I. General information

NPI: 1609077858
Provider Name (Legal Business Name): GABRIEL OGAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 NE 22ND ST APT 1001
MIAMI FL
33137-5107
US

IV. Provider business mailing address

1611 NW 12TH AVE JMH SURGERY
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 786-308-1204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: