1033102090 NPI number — GAIL D WAINGER MD

Table of content: GAIL D WAINGER MD (NPI 1033102090)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033102090 NPI number — GAIL D WAINGER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WAINGER
Provider First Name:
GAIL
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033102090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7910 LOS PINOS CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33143-6472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-279-6577
Provider Business Mailing Address Fax Number:
305-668-9729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19501 NE 10TH AVE
Provider Second Line Business Practice Location Address:
# 305
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33179-3576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-279-6577
Provider Business Practice Location Address Fax Number:
305-668-9729
Provider Enumeration Date:
08/25/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  0019236 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)