Provider Demographics
NPI:1558722157
Name:MCINTYRE, GABRIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5983 50TH AVE N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-3504
Mailing Address - Country:US
Mailing Address - Phone:212-433-0949
Mailing Address - Fax:
Practice Address - Street 1:5983 50TH AVE N
Practice Address - Street 2:
Practice Address - City:KENNETH CITY
Practice Address - State:FL
Practice Address - Zip Code:33709-3504
Practice Address - Country:US
Practice Address - Phone:212-433-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist