MEDICARE: GABRIEL MARTIN DESCHAMPS MD

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	207R00000X	Internal Medicine Physician	ME76219	FL

General Provider Information

NPI Number	:	1538157409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL MARTIN DESCHAMPS MD

Provider Business Mailing Address
First Line	:	6161 SUNSET DR
Second Line	:	STE C
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5045
Country	:	US
Telephone Number	:	305-447-4923
Fax Number	:

Provider Business Practice Location Address
First Line	:	6161 SUNSET DR
Second Line	:	STE C
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5045
Country	:	US
Telephone Number	:	305-447-4923
Fax Number	:

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	04/25/2020

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