MEDICARE: MALIA S GAVIGAN APRN

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
1	208M00000X	Hospitalist Physician	APRN11001047	FL
2	363LA2200X	Adult Health Nurse Practitioner	APRN11001047	FL
3	363L00000X	Nurse Practitioner	APRN11001047	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	L8207	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871055350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALIA S GAVIGAN APRN

Provider Business Mailing Address
First Line	:	3300 S FISKE BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4306
Country	:	US
Telephone Number	:	321-549-0573
Fax Number	:

Provider Business Practice Location Address
First Line	:	1223 GATEWAY DR
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-2607
Country	:	US
Telephone Number	:	321-549-0573
Fax Number	:	321-952-2330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2019
Last Update Date	:	12/29/2025

Similar Medicare Providers

1417460692 — JAMIE LYNNE VANAUKER APRN
Practice Location Address:

1223 GATEWAY DR
MELBOURNE, FL
32901-2607

Practice Phone: 321-312-3321
Practice Fax: 321-409-3685

1023748803 — JASMINE MONTANEZ APRN
Practice Location Address:

1223 GATEWAY DR
MELBOURNE, FL
32901-2607

Practice Phone: 321-312-3328
Practice Fax:

1508674425 — TERRY BAILEY
Practice Location Address:

1223 GATEWAY DR
MELBOURNE, FL
32901-2607

Practice Phone: 321-312-3492
Practice Fax:

1023017530 — DR. TIMOTHY ORPHANIDES MD
Practice Location Address:

1223 GATEWAY DR STE 2B
MELBOURNE, FL
32901-2607

Practice Phone: 321-549-0736
Practice Fax: 321-952-2330

1245230978 — STEPHEN HUGH MACDONALD DO
Practice Location Address:

1223 GATEWAY DR STE 2H
MELBOURNE, FL
32901-2607

Practice Phone: 321-725-4500
Practice Fax: 321-434-8881

1144220880 — DR. RAMESH NARINE GIRJASHANKER MD
Practice Location Address:

1223 GATEWAY DR # 1C
MELBOURNE, FL
32901-2607

Practice Phone: 321-434-3131
Practice Fax:

Directions to “ MALIA S GAVIGAN APRN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.