Provider Demographics
NPI:1306678255
Name:MAYERSON, GABRIEL KWAME (DNP)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:KWAME
Last Name:MAYERSON
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1075 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8360
Mailing Address - Country:US
Mailing Address - Phone:386-917-0333
Mailing Address - Fax:386-917-0335
Practice Address - Street 1:1075 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8360
Practice Address - Country:US
Practice Address - Phone:386-917-0333
Practice Address - Fax:386-917-0335
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11034886207RC0200X, 207RP1001X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease