Provider Demographics
NPI:1235936048
Name:VERDURA, GABRIELA (DC)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:VERDURA
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 BEECHFERN CIR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-6407
Mailing Address - Country:US
Mailing Address - Phone:786-925-1415
Mailing Address - Fax:
Practice Address - Street 1:100 PONTIAC BUSINESS CENTER DR STE B
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-9171
Practice Address - Country:US
Practice Address - Phone:786-925-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor