Individual
MALIA S GAVIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 549-0573
(321) 952-2330
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 549-0573
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
APRN11001047
FL
363L00000X
Nurse Practitioner
APRN11001047
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11001047
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102499500
—
FL
01
—
L8207
MEDICARE
FL
Enumeration date
04/03/2019
Last updated
12/29/2025
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