Provider Demographics
NPI:1336553429
Name:OLIVARES, GABRIELA ISABEL (OD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ISABEL
Last Name:OLIVARES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1732 UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-432-7711
Mailing Address - Fax:954-432-8017
Practice Address - Street 1:1732 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-432-7711
Practice Address - Fax:954-432-8017
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist