Provider Demographics
NPI:1750518924
Name:SHIRE, GABRIELA (PT)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:SHIRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:STEIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5550 WITNEY DR
Mailing Address - Street 2:APT 202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-4036
Mailing Address - Country:US
Mailing Address - Phone:843-819-5411
Mailing Address - Fax:
Practice Address - Street 1:1 STILL HOPES DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7164
Practice Address - Country:US
Practice Address - Phone:843-819-5411
Practice Address - Fax:803-796-1973
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist