Healthcare Provider Details

I. General information

NPI: 1710056858
Provider Name (Legal Business Name): GABRIEL ARTEMIO ARCILA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 SW 152ND ST
PALMETTO BAY FL
33157-1778
US

IV. Provider business mailing address

1400 NW 12TH AVE
MIAMI FL
33136-1003
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-2500
  • Fax:
Mailing address:
  • Phone: 305-243-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberME94293
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME94293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: