Provider Demographics
NPI:1033102090
Name:WAINGER, GAIL D (MD)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:D
Last Name:WAINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 LOS PINOS CIR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6472
Mailing Address - Country:US
Mailing Address - Phone:305-279-6577
Mailing Address - Fax:305-668-9729
Practice Address - Street 1:19501 NE 10TH AVE
Practice Address - Street 2:# 305
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-3576
Practice Address - Country:US
Practice Address - Phone:305-279-6577
Practice Address - Fax:305-668-9729
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00192362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D59788Medicare UPIN
91723Medicare ID - Type Unspecified