Provider Demographics
NPI:1073290631
Name:HINTON, GABRIELLE (OD LLC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:OD LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 INDIAN RIVER BLVD APT 8
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5269
Mailing Address - Country:US
Mailing Address - Phone:772-925-9921
Mailing Address - Fax:772-770-4617
Practice Address - Street 1:792 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-4701
Practice Address - Country:US
Practice Address - Phone:772-770-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist