Provider Demographics
NPI:1316007248
Name:GABRY, KAMAL ELDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:ELDIN
Last Name:GABRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9723 WYETH CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6401
Mailing Address - Country:US
Mailing Address - Phone:646-662-9657
Mailing Address - Fax:
Practice Address - Street 1:12773 FOREST HILL BLVD STE 1213
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4760
Practice Address - Country:US
Practice Address - Phone:561-510-4355
Practice Address - Fax:561-336-9192
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126599207R00000X, 208D00000X, 2084P0015X
NY229866207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME152327OtherMEDICAL LICENSE