Provider Demographics
NPI:1568696052
Name:GABRIEL, JOSE LUIS (EMT)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HCO1 BOX 4770
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:787-201-8554
Mailing Address - Fax:
Practice Address - Street 1:CALLE PEDRO MORA ACOSTA # 40
Practice Address - Street 2:URB. SAN LORENZO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614
Practice Address - Country:US
Practice Address - Phone:787-880-7878
Practice Address - Fax:787-881-6464
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2266146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic