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NPI Code Detail

MEDICARE: DR. ALEXIS GERALDO GONZALEZ PHARMD

MEDICARE: DR. ALEXIS GERALDO GONZALEZ PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPS59818FL

General Provider Information

NPI Number : 1396679981
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXIS GERALDO GONZALEZ PHARMD
Provider Business Mailing Address
First Line : 2625 WASHINGTON ST
Second Line :
City : MELBOURNE
State : FL
Zip : 32904-6313
Country : US
Telephone Number : 305-720-9887
Fax Number :
Provider Business Practice Location Address
First Line : 1425 MALABAR RD NE
Second Line :
City : PALM BAY
State : FL
Zip : 32907-2506
Country : US
Telephone Number : 321-434-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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