Healthcare Provider Details

I. General information

NPI: 1285245878
Provider Name (Legal Business Name): PLATINUM HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W UNIVERSITY AVE STE B
GAINESVILLE FL
32601-5685
US

IV. Provider business mailing address

214 W UNIVERSITY AVE STE B
GAINESVILLE FL
32601-5685
US

V. Phone/Fax

Practice location:
  • Phone: 352-559-4334
  • Fax:
Mailing address:
  • Phone: 352-559-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARIZA PARSONS LOPEZ
Title or Position: OWNER
Credential: APRN, FNP-BC
Phone: 352-559-4334