Gavigan, Malia S
Gavigan, Malia S is an sole proprietor health care provider with primary practice located at 701 W Cocoa Beach Cswy , Cocoa Beach FL 32931-3585. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Gavigan, Malia S can be contacted via phone (321) 868-5871.Contact Information
Primary practice address
701 W Cocoa Beach Cswy
Cocoa Beach FL 32931-3585
Phone: (321) 868-5871
Fax: (321) 868-5852
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | APRN11001047 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | APRN11001047 | Florida |
Profile Details
| NPI number | 1871055350 |
|---|---|
| LBN Legal business name | Gavigan, Malia S |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 3rd, 2019 |
| Last updated | Aug 3rd, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871055350 | NPPES |
| Florida | MEDICAID | 102499500 | |
| Florida | Other | L8207 |
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