Healthcare Provider Details

I. General information

NPI: 1528973559
Provider Name (Legal Business Name): MIND WELLNESS PSYCHIATRY SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 WOODSTORK DR
TEMPLE TERRACE FL
33637-0951
US

IV. Provider business mailing address

1032 E BRANDON BLVD # 7708
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 312-672-9779
  • Fax:
Mailing address:
  • Phone: 312-672-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GURKIRAN KAUR GILL
Title or Position: OWNER
Credential: MD
Phone: 312-672-9779