MEDICARE: DR. ELENA MIRELA GABOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	34175	KY
2	207R00000X	Internal Medicine Physician	ME98013	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417909821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELENA MIRELA GABOR M.D.

Provider Business Mailing Address
First Line	:	4106 W LAKE MARY BLVD
Second Line	:	SUITE 100
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3315
Country	:	US
Telephone Number	:	407-333-2273
Fax Number	:	407-333-2273

Provider Business Practice Location Address
First Line	:	4106 W LAKE MARY BLVD
Second Line	:	SUITE 100
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3315
Country	:	US
Telephone Number	:	407-333-2273
Fax Number	:	407-333-2273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	02/09/2022

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