Provider Demographics
NPI:1760377337
Name:GAGE, ARIEL
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:GAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:VICTORIA
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6060 TWILIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-6556
Mailing Address - Country:US
Mailing Address - Phone:850-758-2381
Mailing Address - Fax:
Practice Address - Street 1:4300 BAYOU BLVD STE 9
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2671
Practice Address - Country:US
Practice Address - Phone:850-637-3992
Practice Address - Fax:850-637-3992
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA102634225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist