MEDICARE: DANIELLY POMBO GAVILAN

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	106S00000X	Behavior Technician	RBT-20-121028	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

General Provider Information

NPI Number	:	1639888464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLY POMBO GAVILAN

Provider Business Mailing Address
First Line	:	19814 NW 48TH CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19814 NW 48TH CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1722
Country	:	US
Telephone Number	:	786-757-2940
Fax Number	:

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

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	11/21/2022

Similar Medicare Providers

1588558423 — ACCESS MEDICAL GROUP OF MIAMI MEDICARE, LLC
Practice Location Address:

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141

1932960630 — DAYALI HERRERA POMBO
Practice Location Address:

19814 NW 48TH CT
MIAMI GARDENS, FL
33055-1722

Practice Phone: 786-881-3882
Practice Fax:

1992833610 — MRS. STACY ELAINE MCINTOSH M.S
Practice Location Address:

101 ALEGRIA WAY
PALM BEACH GARDENS, FL
33418-1722

Practice Phone: 561-506-6400
Practice Fax:

1972267920 — LENNOX MEDICAL SUPPLIES INC
Practice Location Address:

7500 NW 25TH ST STE 241
MIAMI, FL
33122-1722

Practice Phone: 800-689-4031
Practice Fax:

1255135448 — EVOLUTION MEDICAL CENTERS INC
Practice Location Address:

7500 NW 25TH ST STE 240
MIAMI, FL
33122-1722

Practice Phone: 786-706-1216
Practice Fax:

1336981406 — ANNIA ALONSO CORDOVA
Practice Location Address:

3702 NW 188TH ST
MIAMI GARDENS, FL
33055-2857

Practice Phone: 786-281-5229
Practice Fax:

Directions to “ DANIELLY POMBO GAVILAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.