Provider Demographics
NPI:1073771846
Name:ANGULO, GABRIELLA (BSN,MSN,ARNP,PMHNP)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:ANGULO
Suffix:
Gender:F
Credentials:BSN,MSN,ARNP,PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13399 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3880
Mailing Address - Country:US
Mailing Address - Phone:305-761-1025
Mailing Address - Fax:954-435-3530
Practice Address - Street 1:13399 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3880
Practice Address - Country:US
Practice Address - Phone:305-761-1025
Practice Address - Fax:954-435-3530
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9177466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily