Individual
GABRIEL JAIME HENAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(352) 548-6000
Mailing address
2143 SW 246TH DR, NEWBERRY, FL 32669-5066
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
ORT290
FL
224P00000X
Prosthetist
Primary
POR189
FL
Other
Enumeration date
02/03/2023
Last updated
06/29/2023
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