| Organization Name: | GATOR CUSTOM MOBILITY, INC. |
| NPI Number: | 1003840083 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY SCOTT SIMS (GENERAL MANAGER) |
| Mailing Address: | 501 Ne 23rd Ave Gainesville |
| State: | FL US |
| Postal Code: | 326098604 |
| Phone Number: | 3523739673 |
| Fax Number: | 3522719070 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 047295 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |