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General NPI Number Information
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NPI Number | 1750835211
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Entity Type | Organization
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Legal Business Name | GAINESVILLE GERIATRIC
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1000 SW 16TH AVE
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City | GAINESVILLE
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State | FL
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Zip | 32601-8425
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Country | US
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Telephone | 352-328-1529
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 NW 43RD ST SUITE 102/387
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City | GAINESVILLE
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State | FL
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Zip | 32606-4484
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Country | US
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Telephone | 352-328-1529
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN F BRANDT
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Credential | MD
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Telephone | 352-514-6476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | L16000146361
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License Number State | FL
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