Healthcare Provider Details

I. General information

NPI: 1669890299
Provider Name (Legal Business Name): FELIPE CADAVID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100287
GAINESVILLE FL
32610-0287
US

IV. Provider business mailing address

1600 SW ARCHER RD BOX 100287
GAINESVILLE FL
32610-0287
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0916
  • Fax:
Mailing address:
  • Phone: 352-265-0916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME157353
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME157353
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: