Healthcare Provider Details

I. General information

NPI: 1336683168
Provider Name (Legal Business Name): BUSINESS CENTRAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 NW 34TH BLVD FL 32605
GAINESVILLE FL
32605-1153
US

IV. Provider business mailing address

5124 SW 82ND TER
GAINESVILLE FL
32608-7406
US

V. Phone/Fax

Practice location:
  • Phone: 352-240-1136
  • Fax:
Mailing address:
  • Phone: 352-514-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberND2174
License Number StateFL

VIII. Authorized Official

Name: BEVERLY KRAUS
Title or Position: MANAGER
Credential: RD, LD, CDE
Phone: 352-514-9798