MEDICARE: GEMINI HEALTH & WELLNESS 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1679031967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEMINI HEALTH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	3793 OLEANDER AVE
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6503
Country	:	US
Telephone Number	:	772-242-0376
Fax Number	:

Provider Business Practice Location Address
First Line	:	3793 OLEANDER AVE
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6503
Country	:	US
Telephone Number	:	772-466-5774
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	CHARLES SCHWARTZ
Credential	:
Telephone Number	:	772-466-5774

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	10/07/2019

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Directions to “GEMINI HEALTH & WELLNESS LLC ” Practice Location

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