Healthcare Provider Details

I. General information

NPI: 1740567171
Provider Name (Legal Business Name): GIZELLE GEDMIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 SE MARICAMP RD
OCALA FL
34471-6201
US

IV. Provider business mailing address

5750 SW 43RD STREET RD
OCALA FL
34474-9550
US

V. Phone/Fax

Practice location:
  • Phone: 352-351-2374
  • Fax:
Mailing address:
  • Phone: 954-857-1784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS45591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: