Provider Demographics
NPI:1093695256
Name:FABLE, GESNER
Entity type:Individual
Prefix:
First Name:GESNER
Middle Name:
Last Name:FABLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 HYPOLUXO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4244
Mailing Address - Country:US
Mailing Address - Phone:786-830-8221
Mailing Address - Fax:561-720-2201
Practice Address - Street 1:1177 HYPOLUXO RD STE 110
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-4244
Practice Address - Country:US
Practice Address - Phone:786-830-8221
Practice Address - Fax:561-720-2201
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL240956376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker