Provider Demographics
NPI:1720598741
Name:MOUNT BORRERO, GABRIELLE (MSN, ARNP, AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:MOUNT BORRERO
Suffix:
Gender:F
Credentials:MSN, ARNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 SE 7TH CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-5702
Mailing Address - Country:US
Mailing Address - Phone:954-478-9927
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE RM 316E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-5578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9299173208M00000X
FLARNP9299173363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist