Healthcare Provider Details

I. General information

NPI: 1932842366
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CAVAZOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

12222 MERIT DR STE 700
DALLAS TX
75251-2237
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0111
  • Fax:
Mailing address:
  • Phone: 210-315-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberW6596
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: