Provider Demographics
NPI:1083660054
Name:ERIC M. GABRIEL, M.D., P.A.
Entity Type:Organization
Organization Name:ERIC M. GABRIEL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:GABRIEL, M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-308-2006
Mailing Address - Street 1:1801 BARRS ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4732
Mailing Address - Country:US
Mailing Address - Phone:904-308-2006
Mailing Address - Fax:904-308-2060
Practice Address - Street 1:1801 BARRS ST
Practice Address - Street 2:SUITE 120
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4732
Practice Address - Country:US
Practice Address - Phone:904-308-2006
Practice Address - Fax:904-308-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80322261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35367YMedicare ID - Type UnspecifiedMEDICARE