Healthcare Provider Details

I. General information

NPI: 1609705813
Provider Name (Legal Business Name): JOHN ROLAND M.ED., ED.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JODIE ROLAND M.ED., ED.S

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 8TH AVE
GAINESVILLE FL
32601-4967
US

IV. Provider business mailing address

1150 NW 8TH AVE
GAINESVILLE FL
32601-4967
US

V. Phone/Fax

Practice location:
  • Phone: 352-513-8551
  • Fax:
Mailing address:
  • Phone: 352-513-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH27518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: