Provider Demographics
NPI:1770904518
Name:FAUBLAS, GILBERT
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:
Last Name:FAUBLAS
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 1:500 NE 2ND ST APT 305
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-3366
Mailing Address - Country:US
Mailing Address - Phone:347-444-3073
Mailing Address - Fax:
Practice Address - Street 1:500 NE 2ND ST APT 305
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3366
Practice Address - Country:US
Practice Address - Phone:347-444-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health