Provider Demographics
NPI:1447848601
Name:GHIVONI, GAL (RN, BSN)
Entity type:Individual
Prefix:
First Name:GAL
Middle Name:
Last Name:GHIVONI
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 426
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5779
Mailing Address - Country:US
Mailing Address - Phone:201-421-5822
Mailing Address - Fax:
Practice Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 426
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5779
Practice Address - Country:US
Practice Address - Phone:201-421-5822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9543658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse