Individual
GREGORY WILLIAM MIRABAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1 BOWEN DR STE 1, KEY LARGO, FL 33037-2902
(305) 704-0313
Mailing address
220 WASHINGTON AVE, HOMESTEAD, FL 33030-6034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ11179
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SZ11179
FL DOH
FL
Enumeration date
12/12/2023
Last updated
12/12/2023
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