Healthcare Provider Details

I. General information

NPI: 1396371399
Provider Name (Legal Business Name): ANNY MANSIM CHENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-2510
US

IV. Provider business mailing address

PO BOX 100284
GAINESVILLE FL
32610-0284
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8778
  • Fax:
Mailing address:
  • Phone: 352-273-8778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTRN30152
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number90032
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101273242
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME173965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: