Provider Demographics
NPI:1326336967
Name:FINK, GABRIELLE (OTR)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:FINK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 MAGNOLIA BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:WESTCHASE
Mailing Address - State:FL
Mailing Address - Zip Code:33626-5429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9633 MAGNOLIA BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:WESTCHASE
Practice Address - State:FL
Practice Address - Zip Code:33626-5429
Practice Address - Country:US
Practice Address - Phone:409-599-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112728225X00000X
FL21239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20-0443488Medicaid