Healthcare Provider Details

I. General information

NPI: 1215302005
Provider Name (Legal Business Name): RUTH LEHMANN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2015
Last Update Date: 12/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 NW 1ST ST
GAINESVILLE FL
32601-5343
US

IV. Provider business mailing address

1485 S SEMORAN BLVD SUITE 1448
WINTER PARK FL
32792-5533
US

V. Phone/Fax

Practice location:
  • Phone: 352-334-0304
  • Fax:
Mailing address:
  • Phone: 321-397-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RUTH DEEVEY LEHMANN
Title or Position: CLINICAL COUNSELOR
Credential: BA, MA
Phone: 352-213-8813