Most Relevant Information
Provider Data
| NPI Number: | 1003416561 |
| Provider Name: | SERGIO JAVIER GARDEAZABAL |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 11007982 |
Most Important Dates
| Enumeration Date: | 10/26/2020 |
| Last Updated: | 10/26/2020 |
Provider Practice Location
11039 W OKEECHOBEE RD UNIT 201
HIALEAH GARDENS
FL
330184256
Practice Location Phone/Fax
| Phone: | 7866305957 |
| Fax: |
Provider Mailing Location
11039 W OKEECHOBEE RD UNIT 201
HIALEAH GARDENS
FL
330184256
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |