Provider Demographics
NPI:1497772248
Name:GABLES MEDICAL CENTER CORP.
Entity Type:Organization
Organization Name:GABLES MEDICAL CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:J
Authorized Official - Last Name:VIZCAINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-446-5446
Mailing Address - Street 1:717 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE # 218
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2060
Mailing Address - Country:US
Mailing Address - Phone:305-446-5446
Mailing Address - Fax:305-446-5426
Practice Address - Street 1:717 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE # 218
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2060
Practice Address - Country:US
Practice Address - Phone:305-446-5446
Practice Address - Fax:305-446-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation