Healthcare Provider Details

I. General information

NPI: 1730895194
Provider Name (Legal Business Name): GEDALIAH HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 S WINTER PARK DR
CASSELBERRY FL
32707-4409
US

IV. Provider business mailing address

78 S WINTER PARK DR
CASSELBERRY FL
32707-4409
US

V. Phone/Fax

Practice location:
  • Phone: 954-253-5419
  • Fax: 321-733-2956
Mailing address:
  • Phone: 954-253-5419
  • Fax: 321-733-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: GUILENE DAVILMAR
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 954-253-5419