Provider Demographics
NPI:1134221401
Name:GAYLE, BABLEY M (DNP)
Entity type:Individual
Prefix:MRS
First Name:BABLEY
Middle Name:M
Last Name:GAYLE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12960 NW 18TH MANOR
Mailing Address - Street 2:
Mailing Address - City:PEMBROOKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028
Mailing Address - Country:US
Mailing Address - Phone:954-430-1087
Mailing Address - Fax:
Practice Address - Street 1:1321 NW 13TH STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:786-263-4120
Practice Address - Fax:305-545-4042
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1055162363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301734600Medicaid
FL301734600Medicaid