Healthcare Provider Details

I. General information

NPI: 1063547677
Provider Name (Legal Business Name): DAVID ALEXANDER CABEZAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALEX CABEZAS M.D.

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5784
US

IV. Provider business mailing address

PO BOX 100237
GAINESVILLE FL
32610-0237
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-5155
  • Fax:
Mailing address:
  • Phone: 352-392-4541
  • Fax: 352-294-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME108022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: