Provider Demographics
NPI:1326732462
Name:NARANJO, GABRIELLE GUADALUPE
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:GUADALUPE
Last Name:NARANJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 SW 163RD PSGE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4577
Mailing Address - Country:US
Mailing Address - Phone:505-562-7595
Mailing Address - Fax:
Practice Address - Street 1:4424 SW 163RD PSGE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4577
Practice Address - Country:US
Practice Address - Phone:505-562-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026398207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services