Provider Demographics
NPI:1942251566
Name:GAZABON, SHIRLEY AMANDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:AMANDA
Last Name:GAZABON
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:1695 NW 9TH AVENUE, SUITE 2423
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-355-8123
Mailing Address - Fax:305-355-8095
Practice Address - Street 1:1695 NW 9TH AVENUE, SUITE 2423
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-4350
Practice Address - Country:US
Practice Address - Phone:305-355-8123
Practice Address - Fax:305-355-8095
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-07-29
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Provider Licenses
StateLicense IDTaxonomies
FLPY7129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical