Individual
ANIBAL ANTONIO GAITAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
1995 E OAKLAND PARK BLVD STE 250, FORT LAUDERDALE, FL 33306-1149
(954) 791-6146
(954) 337-2733
Mailing address
6195 W 19TH AVE APT 304A, HIALEAH, FL 33012-6079
(305) 742-5462
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-526
FL
Other
Enumeration date
09/21/2017
Last updated
07/21/2022
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