MEDICARE: MRS. GRETCHEN L GAEBEL PA-C

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
1	363AM0700X	Medical Physician Assistant	PA9101775	FL

General Provider Information

NPI Number	:	1831285832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GRETCHEN L GAEBEL PA-C

Provider Business Mailing Address
First Line	:	514 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-5108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	514 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34984-5108
Country	:	US
Telephone Number	:	772-871-5900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	02/25/2026

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