Provider Demographics
NPI:1891705158
Name:GUBIEDA, EFREM (MD)
Entity Type:Individual
Prefix:MR
First Name:EFREM
Middle Name:
Last Name:GUBIEDA
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 1:4141 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2057
Mailing Address - Country:US
Mailing Address - Phone:305-442-1740
Mailing Address - Fax:
Practice Address - Street 1:4141 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2057
Practice Address - Country:US
Practice Address - Phone:305-442-1740
Practice Address - Fax:305-442-2207
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069489208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0379244700Medicaid
G26227Medicare UPIN
FL0379244700Medicaid