Individual
GABRIEL BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 415-8180
Mailing address
PO BOX 889, CHIPLEY, FL 32428-0889
(850) 638-1610
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
FLME0091050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270506100
—
FL
Enumeration date
07/25/2006
Last updated
11/04/2015
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