Healthcare Provider Details

I. General information

NPI: 1225878200
Provider Name (Legal Business Name): GEORGE NASSIF DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 NW 43RD ST STE 16
GAINESVILLE FL
32606-6676
US

IV. Provider business mailing address

17801 SE 109TH AVE
SUMMERFIELD FL
34491-8967
US

V. Phone/Fax

Practice location:
  • Phone: 352-449-3737
  • Fax:
Mailing address:
  • Phone: 352-480-5732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN29188
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: