Healthcare Provider Details

I. General information

NPI: 1013597947
Provider Name (Legal Business Name): RAMIN DANESHVAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 W NEWBERRY RD
GAINESVILLE FL
32605-4305
US

IV. Provider business mailing address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-2020
  • Fax: 352-273-8787
Mailing address:
  • Phone: 352-273-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMFC1839
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number1839
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: