Healthcare Provider Details

I. General information

NPI: 1831461458
Provider Name (Legal Business Name): JONATHAN HU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 W NEWBERRY RD
GAINESVILLE FL
32605-4305
US

IV. Provider business mailing address

6201 W NEWBERRY RD
GAINESVILLE FL
32605-4305
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301106794
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD461141
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number297595
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME158220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: