Healthcare Provider Details

I. General information

NPI: 1760745574
Provider Name (Legal Business Name): GAINESVILLE HEALTH & WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7731 W NEWBERRY RD
GAINESVILLE FL
32606-9246
US

IV. Provider business mailing address

7731 W NEWBERRY RD
GAINESVILLE FL
32606-9246
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-0833
  • Fax: 352-333-0836
Mailing address:
  • Phone: 352-333-0833
  • Fax: 352-333-0836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE JAY KAMMERMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 352-333-0833