Healthcare Provider Details

I. General information

NPI: 1184201816
Provider Name (Legal Business Name): POOJA GURNANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER ROAD
GAINESVILLE FL
32610-3001
US

IV. Provider business mailing address

PO BOX 100279
GAINESVILLE FL
32610-0279
US

V. Phone/Fax

Practice location:
  • Phone: 352-594-1942
  • Fax: 352-594-1926
Mailing address:
  • Phone: 352-594-1942
  • Fax: 352-594-1926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME173215
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: