Healthcare Provider Details
I. General information
NPI: 1841028131
Provider Name (Legal Business Name): GABRIELA SABANILLA TREJO MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/26/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 36TH ST
VERO BEACH FL
32960-4862
US
IV. Provider business mailing address
1455 90TH AVE
VERO BEACH FL
32966-7505
US
V. Phone/Fax
- Phone: 877-463-2010
- Fax:
- Phone: 772-501-3398
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | ND13406 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: