Provider Demographics
NPI:1720832819
Name:MINIAS, GABRIEL ERIAN
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ERIAN
Last Name:MINIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-2014
Mailing Address - Country:US
Mailing Address - Phone:615-545-8874
Mailing Address - Fax:
Practice Address - Street 1:1713 6TH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-2014
Practice Address - Country:US
Practice Address - Phone:205-934-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-195900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse