Healthcare Provider Details

I. General information

NPI: 1548424328
Provider Name (Legal Business Name): SHAND'S HOSPITAL OF UF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SW 62ND BLVD H-46
GAINESVILLE FL
32607-5918
US

IV. Provider business mailing address

900 SW 62ND BLVD H-46
GAINESVILLE FL
32607-5918
US

V. Phone/Fax

Practice location:
  • Phone: 352-642-2828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number12588
License Number StateFL

VIII. Authorized Official

Name: DR. KAMAL OTHMAN SHEMISA
Title or Position: RESIDENT
Credential: MD
Phone: 352-642-2828