Healthcare Provider Details

I. General information

NPI: 1073596235
Provider Name (Legal Business Name): JOHN E DAVID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 NW 16TH AVE
GAINESVILLE FL
32601-4012
US

IV. Provider business mailing address

810 NW 16TH AVE
GAINESVILLE FL
32601-4012
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5700
  • Fax: 352-376-4975
Mailing address:
  • Phone: 352-333-5700
  • Fax: 352-376-4975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME131686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: