Provider Demographics
NPI:1134406606
Name:SMITH, GABRIELA (APRN)
Entity type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:5935 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542
Mailing Address - Country:US
Mailing Address - Phone:813-782-7778
Mailing Address - Fax:813-782-2361
Practice Address - Street 1:5935 7TH STREET
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542
Practice Address - Country:US
Practice Address - Phone:813-782-7778
Practice Address - Fax:813-782-2361
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9270009363LF0000X, 363L00000X
IL209008929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007653500Medicaid
FLGG131WMedicare PIN
ILIL3270598Medicare PIN