Provider Demographics
NPI:1407274491
Name:VILCHEZ, GABRIEL ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ALEJANDRO
Last Name:VILCHEZ
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 1:227 PROFESSIONAL WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6392
Mailing Address - Country:US
Mailing Address - Phone:561-318-8440
Mailing Address - Fax:855-436-5466
Practice Address - Street 1:227 PROFESSIONAL WAY
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6392
Practice Address - Country:US
Practice Address - Phone:561-318-8440
Practice Address - Fax:855-436-5456
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01088936A207R00000X, 207RI0200X
KY53284207RI0200X
FL163821207RI0200X
NMMD2022-1515207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine