Provider Demographics
NPI:1134666712
Name:RICCIO, GABRIELLA MARIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLA
Middle Name:MARIA
Last Name:RICCIO
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:525 RACQUET CLUB RD
Mailing Address - Street 2:APT 47
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1807
Mailing Address - Country:US
Mailing Address - Phone:954-850-0782
Mailing Address - Fax:
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:# 201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2385
Practice Address - Country:US
Practice Address - Phone:954-382-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9362302363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse