Provider Demographics
NPI:1699121574
Name:ADRIANA GABALDON II
Entity type:Organization
Organization Name:ADRIANA GABALDON II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABALDON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-455-1018
Mailing Address - Street 1:3877 TAMIAMI TRL E UNIT 140
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6230
Mailing Address - Country:US
Mailing Address - Phone:239-287-6894
Mailing Address - Fax:
Practice Address - Street 1:3877 TAMIAMI TRL E UNIT 140
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6230
Practice Address - Country:US
Practice Address - Phone:239-287-6894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18595261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental