Healthcare Provider Details

I. General information

NPI: 1013407857
Provider Name (Legal Business Name): ZUNNAIRA ABBASI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR RM D1-17
GAINESVILLE FL
32610-3006
US

IV. Provider business mailing address

1395 CENTER DR RM D1-17
GAINESVILLE FL
32610-3006
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5440
  • Fax: 352-273-5446
Mailing address:
  • Phone: 352-273-5440
  • Fax: 352-273-5446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDRPM2438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: