Provider Demographics
NPI:1275875650
Name:PRATO, GABRIELLE ANN (DO)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ANN
Last Name:PRATO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8095 S KEWAUNEE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-6227
Mailing Address - Country:US
Mailing Address - Phone:305-903-3312
Mailing Address - Fax:
Practice Address - Street 1:2001 N HIGH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5555
Practice Address - Country:US
Practice Address - Phone:720-754-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13837208000000X
CODR.0062267208000000X
FLUO3449390200000X
COCDRH.0062267208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017874200Medicaid