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General NPI Number Information
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NPI Number | 1174318067
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Entity Type | Organization
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Legal Business Name | PROXIMITY WELLNESS, LLC
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 352-217-1982
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 292
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City | ASTATULA
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State | FL
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Zip | 34705-0292
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Country | US
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Telephone | 407-279-1004
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. JAMIE DUANE GUY
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 407-279-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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