Provider Demographics
NPI:1780327221
Name:GABRIEL, SIMAO COXI
Entity type:Individual
Prefix:
First Name:SIMAO
Middle Name:COXI
Last Name:GABRIEL
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 1:2020 S ONEIDA ST STE 14
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2453
Mailing Address - Country:US
Mailing Address - Phone:303-731-1384
Mailing Address - Fax:303-731-6936
Practice Address - Street 1:2020 S ONEIDA ST STE 14
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2453
Practice Address - Country:US
Practice Address - Phone:303-731-1384
Practice Address - Fax:303-731-6936
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000-136-0860343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)