Healthcare Provider Details

I. General information

NPI: 1720422314
Provider Name (Legal Business Name): GAJA FERBEZAR SHAUGHNESSY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GAJA FERBEZAR

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 MEDICAL BLVD STE 101
NAPLES FL
34110-1426
US

IV. Provider business mailing address

PO BOX 112019
NAPLES FL
34108-0134
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8250
  • Fax: 239-624-8251
Mailing address:
  • Phone: 239-624-8250
  • Fax: 239-624-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME126088
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME126088
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME126088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: