MEDICARE: GPS MEDICAL 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	207Q00000X	Family Medicine Physician	0S7764	FL

General Provider Information

NPI Number	:	1487193579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GPS MEDICAL LLC

Provider Business Mailing Address
First Line	:	499 E CENTRAL PKWY STE 100
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3449
Country	:	US
Telephone Number	:	407-543-3461
Fax Number	:	407-678-0627

Provider Business Practice Location Address
First Line	:	499 E CENTRAL PKWY STE 100
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3449
Country	:	US
Telephone Number	:	407-543-3461
Fax Number	:	407-678-0627

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. SUE DUNNINGTON
Credential	:	BS
Telephone Number	:	407-678-5554

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	02/11/2020

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Directions to “GPS MEDICAL LLC ” Practice Location

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