Provider Demographics
NPI:1104241876
Name:GELBSPAN, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:GELBSPAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NE 183RD ST
Mailing Address - Street 2:UNIT 307
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4476
Mailing Address - Country:US
Mailing Address - Phone:786-302-2844
Mailing Address - Fax:
Practice Address - Street 1:3301 NE 183RD ST
Practice Address - Street 2:UNIT 307
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-4476
Practice Address - Country:US
Practice Address - Phone:786-302-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-1788265Medicaid