Provider Demographics
NPI:1316951734
Name:GORZELNIK, GABRIELLE M (PA-C)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:M
Last Name:GORZELNIK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:105 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2119
Mailing Address - Country:US
Mailing Address - Phone:941-308-7546
Mailing Address - Fax:941-308-7550
Practice Address - Street 1:5911 N HONORE AVE
Practice Address - Street 2:STE 210
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2606
Practice Address - Country:US
Practice Address - Phone:941-308-7546
Practice Address - Fax:941-308-7550
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00142100363A00000X
FLPA 9108515363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ62035Medicare UPIN
NJ097708P5LMedicare ID - Type Unspecified