Healthcare Provider Details

I. General information

NPI: 1356702401
Provider Name (Legal Business Name): GUIDEWELL EMERGENCY MEDICINE DOCTORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9580 W COLONIAL DR
OCOEE FL
34761
US

IV. Provider business mailing address

4800 DEERWOOD CAMPUS PKWY FL DC1004
JACKSONVILLE FL
32246-8317
US

V. Phone/Fax

Practice location:
  • Phone: 904-854-7911
  • Fax:
Mailing address:
  • Phone: 321-888-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number25561
License Number StateFL

VIII. Authorized Official

Name: SONDRA TUCKER
Title or Position: VICE PRESIDENT OF DEVELOPMENT
Credential:
Phone: 904-905-7654