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General NPI Number Information
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NPI Number | 1851933709
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Entity Type | Organization
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Legal Business Name | GEO HEALTH NETWORK, LLC
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 3505 LAKE LYNDA DR STE 200
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City | ORLANDO
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State | FL
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Zip | 32817-8333
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Country | US
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Telephone | 800-203-9650
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Fax |
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Provider Business Mailing Address
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Address Line | 209 PINE GLEN CT
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4043
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Country | US
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Telephone | 800-203-9650
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Fax |
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Authorized Official
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Title or Position | PARTNER/CHIEF CLINICAL OFFICER
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Name | DR. TIM LLOYD
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Credential | PHD
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Telephone | 407-473-4057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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