Organization
GAWDY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAJE LAKE (PROVIDER)
(352) 509-6359
Entity
Organization
Contact information
Practice address
923 N MAGNOLIA AVE STE 1300, OCALA, FL 34475-5133
(352) 509-6359
Mailing address
923 N MAGNOLIA AVE STE 1300, OCALA, FL 34475-5133
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/22/2022
Last updated
01/22/2022
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