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General NPI Number Information
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NPI Number | 1376768358
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Entity Type | Individual
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Provider Name | GABRIEL ISA MADRONE M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 800 N APACHE AVE 1100 COLORADO AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-3819
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Country | US
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Telephone | 928-288-8300
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Fax | 928-288-8393
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Provider Business Mailing Address
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Address Line | PO BOX 271
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City | WINSLOW
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State | AZ
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Zip | 86047-0271
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Country | US
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Telephone | 928-288-8300
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Fax | 928-288-8393
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | AZ
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