Healthcare Provider Details

I. General information

NPI: 1457917478
Provider Name (Legal Business Name): GABRIEL F. NEVES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 CORAL SANDS DR STE B
ROCKLEDGE FL
32955-2748
US

IV. Provider business mailing address

211 CORAL SANDS DR STE B
ROCKLEDGE FL
32955-2748
US

V. Phone/Fax

Practice location:
  • Phone: 321-345-6331
  • Fax: 321-345-3295
Mailing address:
  • Phone: 321-345-6331
  • Fax: 321-345-3295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2023009297
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME170643
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: