Provider Demographics
NPI:1053626317
Name:GAVISH, SHLOMI (DOM, AP)
Entity type:Individual
Prefix:DR
First Name:SHLOMI
Middle Name:
Last Name:GAVISH
Suffix:
Gender:M
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11098 BISCAYNE BOULEVARD SUITE 401-4
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161
Mailing Address - Country:US
Mailing Address - Phone:305-909-0621
Mailing Address - Fax:888-770-6887
Practice Address - Street 1:11098 BISCAYNE BOULEVARD SUITE 401-4
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:305-909-0621
Practice Address - Fax:888-770-6887
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2710171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist