Individual
GABRIELA FENOLLAL MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1303 W KENNEDY BLVD, TAMPA, FL 33606-1848
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
2020017927
MO
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME175256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128812400
—
FL
01
—
ZKQ4X
BCBS
FL
Enumeration date
06/12/2019
Last updated
11/15/2025
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