Provider Demographics
NPI:1609656628
Name:GABLES ISMILE
Entity Type:Organization
Organization Name:GABLES ISMILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RONQUILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-390-5716
Mailing Address - Street 1:2725 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6004
Mailing Address - Country:US
Mailing Address - Phone:305-396-1026
Mailing Address - Fax:
Practice Address - Street 1:2725 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6004
Practice Address - Country:US
Practice Address - Phone:305-396-1026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty