Provider Demographics
NPI:1639755663
Name:BARBOZA ROSA, GABRIELA YUSARA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:YUSARA
Last Name:BARBOZA ROSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SIESTA KEY CIR APT 3222
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-7728
Mailing Address - Country:US
Mailing Address - Phone:561-317-1696
Mailing Address - Fax:
Practice Address - Street 1:621 SIESTA KEY CIR APT 3222
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-7728
Practice Address - Country:US
Practice Address - Phone:561-317-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FL11041551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171M00000XOther Service ProvidersCase Manager/Care Coordinator