Provider Demographics
NPI:1639636509
Name:GABRIEL, SHERLY (NP)
Entity Type:Individual
Prefix:
First Name:SHERLY
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERLY
Other - Middle Name:
Other - Last Name:DESORMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15609 SW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5618
Mailing Address - Country:US
Mailing Address - Phone:786-246-1951
Mailing Address - Fax:
Practice Address - Street 1:15609 SW 54TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5618
Practice Address - Country:US
Practice Address - Phone:786-223-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9164838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily