Basic Information
Provider Information
NPI: 1447591516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GABRIELSKI
FirstName: ANGELIKA
MiddleName: AUGUSTA
NamePrefix: MRS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1425 CARRIAGE OAK CT
Address2:  
City: OCOEE
State: FL
PostalCode: 347611442
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 100 N DEAN RD
Address2: SUITE 101
City: ORLANDO
State: FL
PostalCode: 328253710
CountryCode: US
TelephoneNumber: 4073847388
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/13/2013
LastUpdateDate: 03/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X9208437FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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