Provider Demographics
NPI:1942207204
Name:GAVIRIA, JOSE M (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:GAVIRIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7800 SW 87TH AVE
Mailing Address - Street 2:B260
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-4590
Mailing Address - Fax:305-279-2278
Practice Address - Street 1:7800 SW 87TH AVE
Practice Address - Street 2:# B260
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-595-4590
Practice Address - Fax:305-279-2278
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2007-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0069346207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG83443Medicare UPIN
13011Medicare PIN