Healthcare Provider Details

I. General information

NPI: 1851201263
Provider Name (Legal Business Name): AHMED ELDEEB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR. GAINESVILLE, FL 32610
GAINESVILLE FL
32608
US

IV. Provider business mailing address

1395 CENTER DR. GAINESVILLE, FL 32610
GAINESVILLE FL
32608
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6705
  • Fax:
Mailing address:
  • Phone: 352-273-6910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDRPM3137
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: