Healthcare Provider Details

I. General information

NPI: 1841258449
Provider Name (Legal Business Name): NAKECHAND R POORAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DIVISION OF GASTROENTEROLOGY AND HEPATOLOGY UNIVERISY OF FLORIDA
GAINESVILLE FL
32610-0214
US

IV. Provider business mailing address

DIVISION OF GASTROENTEROLOGY AND HEPATOLOGY UNIVERISY OF FLORIDA, PO BOX 100214
GAINESVILLE FL
32610-0214
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9472
  • Fax: 352-627-9002
Mailing address:
  • Phone: 352-273-9472
  • Fax: 352-627-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME120153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: