Provider Demographics
NPI:1629529045
Name:NEMZOW, GABRIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:NEMZOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GABRIEL
Other - Middle Name:
Other - Last Name:WEINGROD NEMZOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4044 N MERIDIAN AVE
Mailing Address - Street 2:APT 3C
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4044 N MERIDIAN AVE
Practice Address - Street 2:APT 3C
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3327
Practice Address - Country:US
Practice Address - Phone:305-332-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN23609207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine