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General NPI Number Information
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NPI Number | 1518325661
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Entity Type | Organization
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Legal Business Name | GABRY WELLNESS CENTER LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 03/28/2016
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Provider Practice Location Address
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Address Line | 12773 FOREST HILL BLVD #1213
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City | WELLINGTON
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State | FL
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Zip | 33414-4767
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Country | US
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Telephone | 561-510-4355
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Fax | 561-336-9192
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Provider Business Mailing Address
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Address Line | 12773 FOREST HILL BLVD #1213
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City | WELLINGTON
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State | FL
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Zip | 33414-4767
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Country | US
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Telephone | 561-510-4355
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Fax | 561-336-9192
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Authorized Official
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Title or Position | OWNER
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Name | KAMAL GABRY
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Credential | M.D.
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Telephone | 561-510-4355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA80691
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME126599
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License Number State | FL
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