Healthcare Provider Details

I. General information

NPI: 1568326130
Provider Name (Legal Business Name): GABRIELA HERNANDEZ MAJLOV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2789 W 9760 S
SOUTH JORDAN UT
84095-3249
US

IV. Provider business mailing address

1979 N 3100 W
PROVO UT
84601-5941
US

V. Phone/Fax

Practice location:
  • Phone: 801-915-0350
  • Fax:
Mailing address:
  • Phone: 801-616-2365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: