Healthcare Provider Details

I. General information

NPI: 1821778911
Provider Name (Legal Business Name): DGS HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 GLENLEIGH DR
OCOEE FL
34761-5730
US

IV. Provider business mailing address

1403 GLENLEIGH DR
OCOEE FL
34761-5730
US

V. Phone/Fax

Practice location:
  • Phone: 850-212-1465
  • Fax:
Mailing address:
  • Phone: 850-212-1465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONNA GERALDINE SAMPSON
Title or Position: CHIEF EXECUTIVE OFFICER/OWNER
Credential: ARNP
Phone: 850-212-1465