Healthcare Provider Details

I. General information

NPI: 1003207770
Provider Name (Legal Business Name): SAMUEL Y. AMOFA-HO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SAMUEL Y. HO JR. MD

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

2804 PRAIRIE IRIS DR
LAND O LAKES FL
34638-7212
US

V. Phone/Fax

Practice location:
  • Phone: 785-845-3981
  • Fax:
Mailing address:
  • Phone: 785-845-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN28590
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: