Healthcare Provider Details

I. General information

NPI: 1154360139
Provider Name (Legal Business Name): HASSAN MARI ALNUAIMAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HASSAN MARI ALNUAIMAT

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER ROAD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8020
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-2666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberME91231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: