MEDICARE: EXGEO, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1164319844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXGEO, LLC

Provider Business Mailing Address
First Line	:	4828 MEG CT
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7334
Country	:	US
Telephone Number	:	512-914-3205
Fax Number	:

Provider Business Practice Location Address
First Line	:	7241 HUMMINGBIRD LN
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-4010
Country	:	US
Telephone Number	:	512-914-3205
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	DEREK GILL
Credential	:	NRP
Telephone Number	:	512-914-3205

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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Directions to “EXGEO, LLC ” Practice Location

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