Provider Demographics
NPI:1679266605
Name:GIL, GABRIELA MARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:MARIA
Last Name:GIL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 SW 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5114
Mailing Address - Country:US
Mailing Address - Phone:786-372-4117
Mailing Address - Fax:
Practice Address - Street 1:9950 SW 107TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2767
Practice Address - Country:US
Practice Address - Phone:305-595-4397
Practice Address - Fax:305-595-4398
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL279351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice