Healthcare Provider Details

I. General information

NPI: 1225610041
Provider Name (Legal Business Name): MICHEL ABDELMASIH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD # G086
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1600 SW ARCHER RD # G086
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0152
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberME173319
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: