Provider Demographics
NPI:1396219085
Name:FELDMAN, GABRIELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:HUMISTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2544 13TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-4333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2803 GULF TO BAY BLVD # 150
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-4014
Practice Address - Country:US
Practice Address - Phone:813-994-3087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1023555695OtherNPPES