Healthcare Provider Details
I. General information
NPI: 1427926435
Provider Name (Legal Business Name): GATORS SPINE & WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 SW 42ND ST STE 3
GAINESVILLE FL
32608-2441
US
IV. Provider business mailing address
3201 SW 42ND ST STE 3
GAINESVILLE FL
32608-2441
US
V. Phone/Fax
- Phone: 352-776-8899
- Fax: --
- Phone: 352-776-8899
- Fax: --
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WENDY
L.
FLYNN
Title or Position: PRES.
Credential: D.C.
Phone: 224-515-6255