Healthcare Provider Details

I. General information

NPI: 1952174757
Provider Name (Legal Business Name): GABBI HEALTH MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8270 WOODLAND CENTER BLVD
TAMPA FL
33614-2401
US

IV. Provider business mailing address

10350 N VANCOUVER WAY # 1067
PORTLAND OR
97217-7530
US

V. Phone/Fax

Practice location:
  • Phone: 503-482-8374
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELLY BECKLEY
Title or Position: CLINICAL OPERATIONS MANAGER
Credential: ANP-BC
Phone: 503-482-8374