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NPI Code Detail

MEDICARE: GABLES PROFESSIONAL MEDICAL GROUP INC

MEDICARE: GABLES PROFESSIONAL MEDICAL GROUP INC
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
1261Q00000XClinic/CenterHCC7165FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HCC7165OTHERFLAHCA LICENSE

General Provider Information

NPI Number : 1689767766
Entity Type Code : Organization
Provider Name (Legal Business Name) : GABLES PROFESSIONAL MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 3934 SW 8TH ST
Second Line : SUITE 308
City : CORAL GABLES
State : FL
Zip : 33134-2949
Country : US
Telephone Number : 305-447-4009
Fax Number : 305-447-4085
Provider Business Practice Location Address
First Line : 3934 SW 8TH ST
Second Line : SUITE 308
City : CORAL GABLES
State : FL
Zip : 33134-2949
Country : US
Telephone Number : 305-447-4009
Fax Number : 305-447-4085
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MS. MARGARITA PARDO
Credential :
Telephone Number : 305-447-4009
Provider Enumeration Date : 10/02/2006
Last Update Date : 08/22/2020

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Directions to “GABLES PROFESSIONAL MEDICAL GROUP INC ” Practice Location

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