Provider Demographics
NPI:1962677161
Name:KIBORT, GABRIELA (PHARM,D)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:KIBORT
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13254 SW 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6021
Mailing Address - Country:US
Mailing Address - Phone:305-259-6963
Mailing Address - Fax:
Practice Address - Street 1:15043 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-7930
Practice Address - Country:US
Practice Address - Phone:786-573-5177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist