Healthcare Provider Details

I. General information

NPI: 1467661686
Provider Name (Legal Business Name): AMAN MEHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER ROAD
GAINESVILLE FL
32608
US

IV. Provider business mailing address

2808 LADY LAKE BOULEVARD
LADY LAKE FL
32159
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-6064
  • Fax:
Mailing address:
  • Phone: 305-775-1317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number07858
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME59223
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME105179
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: