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Individual

DR. TODD JACOB GATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2020 COMMERCE DR, WEST MELBOURNE, FL 32904-2335
(321) 952-6000
Mailing address
400 SHERIDAN RD, MELBOURNE, FL 32901-3184
(321) 722-5200
(321) 953-7510

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
34-004091
OH
2084P0800X
Psychiatry Physician
Primary
OS10754
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003039300
FL
Enumeration date
07/01/2005
Last updated
07/16/2021
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