Healthcare Provider Details

I. General information

NPI: 1881012243
Provider Name (Legal Business Name): FUNCTIONAL HEALTH AND MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 SE 16TH AVE SUITE 303
OCALA FL
34471-4620
US

IV. Provider business mailing address

1720 SE 16TH AVE SUITE 303
OCALA FL
34471-4620
US

V. Phone/Fax

Practice location:
  • Phone: 352-512-0907
  • Fax: 352-512-0976
Mailing address:
  • Phone: 352-512-0907
  • Fax: 352-512-0976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberOS 12487
License Number StateFL

VIII. Authorized Official

Name: BILL REED
Title or Position: MANAGING MEMBER
Credential:
Phone: 352-512-0907