Healthcare Provider Details

I. General information

NPI: 1922946011
Provider Name (Legal Business Name): MARVEN GEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

858 GRAND REGENCY POINTE UNIT 104
ALTAMONTE SPRINGS FL
32714-3582
US

IV. Provider business mailing address

858 GRAND REGENCY POINTE UNIT 104
ALTAMONTE SPRINGS FL
32714-3582
US

V. Phone/Fax

Practice location:
  • Phone: 407-719-0979
  • Fax: 407-719-0979
Mailing address:
  • Phone: 407-719-0979
  • Fax: 407-719-0979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM.0107627-P
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: