Provider Demographics
NPI:1336497064
Name:ADRIANA GABALDON DDS
Entity Type:Organization
Organization Name:ADRIANA GABALDON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABALDON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-455-1018
Mailing Address - Street 1:12355 COLLIER BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NAPES
Mailing Address - State:FL
Mailing Address - Zip Code:34116
Mailing Address - Country:US
Mailing Address - Phone:239-455-1018
Mailing Address - Fax:239-455-2464
Practice Address - Street 1:12355 COLLIER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6027
Practice Address - Country:US
Practice Address - Phone:239-455-1018
Practice Address - Fax:239-455-2464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18595261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental