Provider Demographics
NPI:1972287647
Name:MARRERO, GABRIEL J
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:J
Last Name:MARRERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 CARIBBEAN BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1224
Mailing Address - Country:US
Mailing Address - Phone:305-707-1555
Mailing Address - Fax:
Practice Address - Street 1:10700 CARIBBEAN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1224
Practice Address - Country:US
Practice Address - Phone:305-707-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist