Provider Demographics
NPI:1922453828
Name:HERRERA, GABRIELA (RD LDN)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14932 SW 21ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5800
Mailing Address - Country:US
Mailing Address - Phone:305-321-6371
Mailing Address - Fax:
Practice Address - Street 1:14932 SW 21ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5800
Practice Address - Country:US
Practice Address - Phone:305-321-6371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 7464133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered