Provider Demographics
NPI:1881011096
Name:GABBARD, CLIFF
Entity Type:Individual
Prefix:
First Name:CLIFF
Middle Name:
Last Name:GABBARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 NE 10TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4482
Mailing Address - Country:US
Mailing Address - Phone:352-215-0204
Mailing Address - Fax:
Practice Address - Street 1:630 NE 10TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4482
Practice Address - Country:US
Practice Address - Phone:352-215-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide