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NPI Code Detail

MEDICARE: GATEWAY COMMUNITY SERVICES, INC.

MEDICARE: GATEWAY COMMUNITY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11659541654OTHERFLNPI
21619411279OTHERFLNPI
31316376585OTHERFLNPI
41689252314OTHERFLNPI
51811393499OTHERFLNPI
61427184308OTHERFLNPI
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124783477
Entity Type Code : Organization
Provider Name (Legal Business Name) : GATEWAY COMMUNITY SERVICES, INC.
Provider Business Mailing Address
First Line : 555 STOCKTON ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32204-2534
Country : US
Telephone Number : 904-387-4661
Fax Number : 904-389-8758
Provider Business Practice Location Address
First Line : 2133 BROADWAY AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32209-7513
Country : US
Telephone Number : 904-361-5010
Fax Number : 904-384-2299
Authorized Official
Title or Position : DIRECTOR OF UM/UR
Name : CYNTHIA MERCADO
Credential :
Telephone Number : 904-718-8606
Provider Enumeration Date : 11/02/2021
Last Update Date : 02/19/2026

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Directions to “GATEWAY COMMUNITY SERVICES, INC. ” Practice Location

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