Healthcare Provider Details

I. General information

NPI: 1952764664
Provider Name (Legal Business Name): GABRIELA ALEJANDRA RIFKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 W SUNRISE BLVD
PLANTATION FL
33322-4103
US

IV. Provider business mailing address

9623 WATERCREST ISLE
PARKLAND FL
33076-2896
US

V. Phone/Fax

Practice location:
  • Phone: 954-474-2900
  • Fax:
Mailing address:
  • Phone: 847-372-3488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME144644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: