Provider Demographics
NPI:1619594215
Name:GUIDEWELL EMERGENCY MEDICINE DOCTORS, LLC
Entity Type:Organization
Organization Name:GUIDEWELL EMERGENCY MEDICINE DOCTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-885-2413
Mailing Address - Street 1:4230 PABLO PROFESSIONAL CT STE 103
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-3223
Mailing Address - Country:US
Mailing Address - Phone:904-885-2413
Mailing Address - Fax:904-647-5559
Practice Address - Street 1:4744 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6509
Practice Address - Country:US
Practice Address - Phone:904-885-2413
Practice Address - Fax:904-647-5559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUIDEWELL EMERGENCY MEDICINE DOCTORS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care