Healthcare Provider Details

I. General information

NPI: 1679488985
Provider Name (Legal Business Name): GABRIELA MONTECELO CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 HOLLOWELL DR
TAMPA FL
33634-1086
US

IV. Provider business mailing address

7243 HOLLOWELL DR
TAMPA FL
33634-1086
US

V. Phone/Fax

Practice location:
  • Phone: 786-905-2470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-26-2831635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: