Healthcare Provider Details

I. General information

NPI: 1497323125
Provider Name (Legal Business Name): GEARITY WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

IV. Provider business mailing address

3000 HUNTERS CREEK BLVD
ORLANDO FL
32837-6901
US

V. Phone/Fax

Practice location:
  • Phone: 407-418-9122
  • Fax:
Mailing address:
  • Phone: 407-857-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLY MCDONAH
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 407-857-2502