Provider Demographics
NPI:1932457322
Name:GABLES MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:GABLES MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-649-0492
Mailing Address - Street 1:759 NW 22 AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-649-0492
Mailing Address - Fax:305-649-0496
Practice Address - Street 1:759 NW 22 AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-649-0492
Practice Address - Fax:305-649-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA 9100823OtherSTATE LICENSE