GABRIEL DIB TAISSOUN (FNP-C) – Surgical Assistant, NPI 1871018630

GABRIEL DIB TAISSOUN (FNP-C) is a healthcare provider. based in Bradenton, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 11027767 (FL). The NPI Number for GABRIEL DIB TAISSOUN (FNP-C) is 1871018630

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
GABRIEL DIB TAISSOUN (FNP-C)
NPI
1871018630
Phone
(321) 900-9818
Address
17523 CANTARINA CV
Enumeration Date
13 August 2017
Last Update Date
28 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9413511200
Graduation Year
2023 (3 years ago)
PAC ID
7810350345
Group Practice PAC ID
2264680768
Professional Enrollment ID
I20230830003146
Address ID
FL342313622SA3906XTRLX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for GABRIEL DIB TAISSOUN (FNP-C)

  • 17523 CANTARINA CV

    BRADENTON, FL 342111126

    Phone: (321) 900-9818

    Type: Mailing

  • 2401 UNIVERSITY PKWY STE 205

    SARASOTA, FL 342432973

    Phone: (941) 351-1200

    Fax: (941) 351-1201

    Type: Location

  • Langstaff Drive, Lake Reams Townhomes at Lakes of Windermere, Lakeside Village, Orange County, Florida, 34786, United States

    WINDERMERE, FL 347869510

    Phone: (321) 900-9818

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230830003146INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34211)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264680768View full group profile
NameSpecialtyState
O P H T H A L M O L O G YVA
O P H T H A L M O L O G YFL
O P H T H A L M O L O G YPA
Physician AssistantFL
O P H T H A L M O L O G YFL
O P H T H A L M O L O G YFL

Reviews

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Frequently asked questions

Can I use this page to confirm GABRIEL DIB TAISSOUN (FNP-C)'s NPI?
Yes. GABRIEL DIB TAISSOUN (FNP-C) is listed with NPI 1871018630 in the public NPI dataset.
Does CMS list GABRIEL DIB TAISSOUN (FNP-C) as active?
Yes — GABRIEL DIB TAISSOUN (FNP-C) is active in the NPI listing used on this page.
What healthcare role does GABRIEL DIB TAISSOUN (FNP-C) hold?
Scheduling teams often label GABRIEL DIB TAISSOUN (FNP-C) under Surgical Assistant. Clinical services aligned with this taxonomy classification.
Where is GABRIEL DIB TAISSOUN (FNP-C) based?
GABRIEL DIB TAISSOUN (FNP-C) is tied to Bradenton, Florida in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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