Provider Demographics
NPI:1932767423
Name:MION, GABRIEL
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MION
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 1:16240 SW 66TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5585
Mailing Address - Country:US
Mailing Address - Phone:305-753-9062
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 155TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5871
Practice Address - Country:US
Practice Address - Phone:305-512-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist