Provider Demographics
NPI:1750759908
Name:SERNA, GABRIELA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:SERNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 SW 72ND ST
Mailing Address - Street 2:SUITE 261
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3251
Mailing Address - Country:US
Mailing Address - Phone:305-271-7343
Mailing Address - Fax:305-271-7949
Practice Address - Street 1:9425 SW 72ND ST
Practice Address - Street 2:SUITE 261
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3251
Practice Address - Country:US
Practice Address - Phone:305-271-7343
Practice Address - Fax:305-271-7949
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ7259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ7259OtherSPEECH LANGUAGE PATHOLOGIST PROVISIONAL