Healthcare Provider Details

I. General information

NPI: 1770510125
Provider Name (Legal Business Name): NAGLAA ZIDAN ELSAYED ABDEL-AL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W NEWBERRY RD STE E3
GAINESVILLE FL
32607-2389
US

IV. Provider business mailing address

4001 W NEWBERRY RD STE E3
GAINESVILLE FL
32607-2389
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-3677
  • Fax: 352-505-3966
Mailing address:
  • Phone: 352-505-3677
  • Fax: 352-505-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME100169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: