Provider Demographics
NPI:1639379761
Name:FLOREZ, GABRIEL GREGORIO (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:GREGORIO
Last Name:FLOREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 SHERIDAN ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3535
Mailing Address - Country:US
Mailing Address - Phone:786-218-1160
Mailing Address - Fax:954-963-1557
Practice Address - Street 1:4440 SHERIDAN ST, SUITE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:786-218-1160
Practice Address - Fax:954-963-1557
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16833208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice