Provider Demographics
NPI:1104105162
Name:GAMBINI, DEBRA ANN (RN)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:GAMBINI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 AVENUE F NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4131
Mailing Address - Country:US
Mailing Address - Phone:863-294-7062
Mailing Address - Fax:863-291-5951
Practice Address - Street 1:1201 1ST ST S
Practice Address - Street 2:SWEET CENTER
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3904
Practice Address - Country:US
Practice Address - Phone:863-294-7062
Practice Address - Fax:863-291-5951
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9328676163W00000X
NY454540-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse