Provider Demographics
NPI:1669086401
Name:GAMEZ CHANG, BARBARA JISSY (APRN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JISSY
Last Name:GAMEZ CHANG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JISSY
Other - Last Name:GAMEZ CICERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:12478 SW 17TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1563
Mailing Address - Country:US
Mailing Address - Phone:786-447-5854
Mailing Address - Fax:
Practice Address - Street 1:12478 SW 17TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1563
Practice Address - Country:US
Practice Address - Phone:786-447-5854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty