Healthcare Provider Details

I. General information

NPI: 1598129983
Provider Name (Legal Business Name): MISSY MA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEIXI MA MD, MS

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 SW 16TH ST
GAINESVILLE FL
32608-1128
US

IV. Provider business mailing address

1329 SW 16TH ST
GAINESVILLE FL
32608-1128
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberTRN41103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: