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General NPI Number Information
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NPI Number | 1295830214
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Entity Type | Individual
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Provider Name | GABRIELLE MARIE REBILLARD L.M.
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9245 SW 157TH ST STE 106
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33157-1975
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Country | US
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Telephone | 305-378-0338
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Fax | 305-378-0339
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Provider Business Mailing Address
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Address Line | 9241 SW 192ND DR
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City | MIAMI
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State | FL
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Zip | 33157-7932
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Country | US
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Telephone | 786-242-4109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | MW149
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License Number State | FL
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