Healthcare Provider Details
I. General information
NPI: 1619771482
Provider Name (Legal Business Name): GUIDEWELL EMERGENCY MEDICINE DOCTORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9580 W COLONIAL DR
OCOEE FL
34761-6947
US
IV. Provider business mailing address
4800 DEERWOOD CAMPUS PARKWAY, DC 100/4TH FLOOR
JACKSONVILLE FL
32246
US
V. Phone/Fax
- Phone: 321-888-2511
- Fax:
- Phone: 904-885-2413
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
N
ANDREWS
Title or Position: VP OF CLINICAL OPERATIONS
Credential: RN
Phone: 904-885-2413