Healthcare Provider Details

I. General information

NPI: 1316527377
Provider Name (Legal Business Name): ALI ELIZABETH WELLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 103204
GAINESVILLE FL
32610-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0335
  • Fax:
Mailing address:
  • Phone: 352-265-0335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME184001
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: