Provider Demographics
NPI:1831061704
Name:GBAGO, VERONICA E (MASTER OF PUB HEALTH)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:E
Last Name:GBAGO
Suffix:
Gender:F
Credentials:MASTER OF PUB HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 BEGONIA CV APT 212
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6521
Mailing Address - Country:US
Mailing Address - Phone:407-319-6686
Mailing Address - Fax:
Practice Address - Street 1:4200 BEGONIA CV APT 212
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6521
Practice Address - Country:US
Practice Address - Phone:407-319-6686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty