1093573982 NPI number — GIFTED IN GREATNESS ABA & PRIVATE SCHOOL

Table of content: DR. GARY WILLIAM PUSHKIN M.D. (NPI 1871587212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093573982 NPI number — GIFTED IN GREATNESS ABA & PRIVATE SCHOOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GIFTED IN GREATNESS ABA & PRIVATE SCHOOL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1093573982
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1970 SE 22ND CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOMESTEAD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33035-1238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-975-4609
Provider Business Mailing Address Fax Number:
866-730-5962

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100125 OVERSEAS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEY LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33037-4423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-975-4609
Provider Business Practice Location Address Fax Number:
866-730-5962
Provider Enumeration Date:
03/06/2024

Additional Information

Authorized Official

Authorized Official Last Name:
MIGLIORI
Authorized Official First Name:
YAMILEE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
786-975-4609

Provider Taxonomy Codes

  • Taxonomy code: 385HR2060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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