Provider Demographics
NPI:1427251206
Name:GIBBS, COLETTE (RN)
Entity type:Individual
Prefix:MR
First Name:COLETTE
Middle Name:
Last Name:GIBBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 SW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3210
Mailing Address - Country:US
Mailing Address - Phone:305-388-5551
Mailing Address - Fax:
Practice Address - Street 1:18055 SW 12TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2715
Practice Address - Country:US
Practice Address - Phone:305-222-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1534422163WA2000X, 163WC0200X, 163WC0400X, 163WE0003X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Not Answered163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WE0003XNursing Service ProvidersRegistered NurseEmergency
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health