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General NPI Number Information
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NPI Number | 1073839718
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Entity Type | Organization
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Legal Business Name | GERIATRIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 5804 INDIAN PINES BLVD
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City | FORT PIERCE
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State | FL
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Zip | 34951-2302
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Country | US
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Telephone | 772-828-3752
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Fax | 772-302-3518
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Provider Business Mailing Address
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Address Line | 5804 INDIAN PINES BLVD
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City | FORT PIERCE
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State | FL
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Zip | 34951-2302
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Country | US
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Telephone | 772-828-3752
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Fax | 772-302-3518
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Authorized Official
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Title or Position | GERIATRIC NURSE PRACTITIONER
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Name | MRS. MADETRIC NAFAYE WOOD
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Credential | ARNP, GNP-BC
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Telephone | 850-322-1895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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