Healthcare Provider Details

I. General information

NPI: 1285676122
Provider Name (Legal Business Name): JOHN H. ABERNETHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 SW 13TH ST
GAINESVILLE FL
32608-4006
US

IV. Provider business mailing address

4300 SW 13TH ST
GAINESVILLE FL
32608-4006
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-5600
  • Fax: 352-374-5608
Mailing address:
  • Phone: 352-374-5600
  • Fax: 352-374-5608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME65809
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberME65809
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberME65809
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: