Healthcare Provider Details

I. General information

NPI: 1366862997
Provider Name (Legal Business Name): SHERINE ABDALLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
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 100214
GAINESVILLE FL
32610-0214
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9400
  • Fax: 352-627-4268
Mailing address:
  • Phone: 352-273-9400
  • Fax: 352-627-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME143896
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME143896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: