Provider Demographics
NPI:1841828498
Name:ANDERSON, GABRIELLE L (DO)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:985 STATE ROAD 436
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5664
Mailing Address - Country:US
Mailing Address - Phone:407-831-5252
Mailing Address - Fax:407-831-3765
Practice Address - Street 1:985 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5664
Practice Address - Country:US
Practice Address - Phone:407-831-5252
Practice Address - Fax:407-831-3765
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS20291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine