1376254672 NPI number — GABRIELA PEREZ, D.O., P.A.

Table of content: (NPI 1376254672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376254672 NPI number — GABRIELA PEREZ, D.O., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GABRIELA PEREZ, D.O., P.A.
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:
1376254672
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1805 PONCE DE LEON BLVD STE 125
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:
33134-4473
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-554-3700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2695 S LE JEUNE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33134-5839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-403-7197
Provider Business Practice Location Address Fax Number:
305-489-8087
Provider Enumeration Date:
12/07/2022

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
GABRIELA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/ PHYSICIAN
Authorized Official Telephone Number:
786-554-3700

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1932630712 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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