Healthcare Provider Details

I. General information

NPI: 1396957916
Provider Name (Legal Business Name): JOSEPH AMDUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 NW 28TH ST
GAINESVILLE FL
32605-3740
US

IV. Provider business mailing address

2220 NW 28TH ST
GAINESVILLE FL
32605-3740
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-1683
  • Fax:
Mailing address:
  • Phone: 352-379-1683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME 9436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: