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General NPI Number Information
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NPI Number | 1952062390
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Entity Type | Individual
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Provider Name | GABRIELLA STEPHANIE URDANETA
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Gender | Female
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 6310 FORT KING RD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-2531
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Country | US
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Telephone | 813-406-4400
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Fax | 813-929-6633
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Provider Business Mailing Address
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Address Line | 27516 CASHFORD CIR STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6910
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Country | US
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Telephone | 813-407-4400
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Fax | 813-929-6633
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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