Healthcare Provider Details

I. General information

NPI: 1508836628
Provider Name (Legal Business Name): GABRIEL M UMANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/06/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 SW STATE RD 200 SUITE 400
OCALA FL
34481
US

IV. Provider business mailing address

2405 SE 17TH ST SUITE 201
OCALA FL
34471-9192
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-1667
  • Fax: 352-861-1659
Mailing address:
  • Phone: 352-690-2171
  • Fax: 352-690-6954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME82039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: