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General NPI Number Information
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NPI Number | 1932986700
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Entity Type | Individual
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Provider Name | NISSIM GABAY
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Gender | Male
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 03/31/2024
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Provider Practice Location Address
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Address Line | 15600 NW 67TH AVE
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2174
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Country | US
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Telephone | 844-665-4827
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Fax |
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Provider Business Mailing Address
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Address Line | 15600 NW 67TH AVE STE 301
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2176
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Country | US
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Telephone | 844-665-4827
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9576952
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F03240584
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License Number State | FL
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