Healthcare Provider Details

I. General information

NPI: 1063331338
Provider Name (Legal Business Name): ACCESSENABLED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KALA CT
BRUNSWICK GA
31525-9506
US

IV. Provider business mailing address

115 KALA CT
BRUNSWICK GA
31525-9506
US

V. Phone/Fax

Practice location:
  • Phone: 912-845-8640
  • Fax:
Mailing address:
  • Phone: 912-845-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: PEDRO GONZALEZ
Title or Position: FOUNDER, AUDITOR
Credential:
Phone: 912-845-8640