Healthcare Provider Details

I. General information

NPI: 1932955374
Provider Name (Legal Business Name): GABRIELLA TROLEZI OLIVEIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S HIAWASSEE RD STE 203
ORLANDO FL
32835-6317
US

IV. Provider business mailing address

12315 LANGSTAFF DR
WINDERMERE FL
34786-9507
US

V. Phone/Fax

Practice location:
  • Phone: 407-286-4031
  • Fax:
Mailing address:
  • Phone: 617-448-6673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1007907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: