Healthcare Provider Details

I. General information

NPI: 1174318067
Provider Name (Legal Business Name): PROXIMITY WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S ORANGE AVE FL 3
ORLANDO FL
32801-3394
US

IV. Provider business mailing address

450 S ORANGE AVE FL 3
ORLANDO FL
32801-3394
US

V. Phone/Fax

Practice location:
  • Phone: 407-686-6888
  • Fax: 407-610-6872
Mailing address:
  • Phone: 407-686-6888
  • Fax: 407-610-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMIE DUANE GUY
Title or Position: CO-OWNER
Credential: MSN, APRN, PMHNP-BC
Phone: 407-279-1004