Gator Support Services LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

GATOR SUPPORT SERVICES LLC

Practice address

643 Willett Dr
Winter Garden, FL 34787-6510

Phone

(407) 621-1518

Fax

(407) 614-2394

NPI assigned

Oct 10, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Damien Adams

Title

Ceo

Phone

(407) 621-1518

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1861942286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 WILLETT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876510",
            "telephone_number": "407-621-1518",
            "fax_number": "407-614-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 WILLETT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876510",
            "telephone_number": "407-621-1518",
            "fax_number": "407-614-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATOR SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAMIEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-621-1518",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.