Healthcare Provider Details
I. General information
NPI: 1003340167
Provider Name (Legal Business Name): GCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2017
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
37 N ORANGE AVE SUITE 500
ORLANDO FL
32801-2449
US
IV. Provider business mailing address
37 N ORANGE AVE SUITE 500
ORLANDO FL
32801-2449
US
V. Phone/Fax
- Phone: 407-926-4016
- Fax: 800-886-6352
- Phone: 407-926-4016
- Fax: 800-886-6352
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SA2200X |
| Taxonomy | Adult Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SH0200X |
| Taxonomy | Home Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WALTER
GIBSON
Title or Position: MANAGER
Credential:
Phone: 407-683-7649