Provider Demographics
NPI:1952062390
Name:URDANETA, GABRIELLA STEPHANIE
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:STEPHANIE
Last Name:URDANETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:27516 CASHFORD CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6910
Mailing Address - Country:US
Mailing Address - Phone:813-407-4400
Mailing Address - Fax:813-929-6633
Practice Address - Street 1:6310 FORT KING RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2531
Practice Address - Country:US
Practice Address - Phone:813-406-4400
Practice Address - Fax:813-929-6633
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2024-12-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant