Healthcare Provider Details

I. General information

NPI: 1093509937
Provider Name (Legal Business Name): IAN TSEKOURAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SW ARCHER RD
GAINESVILLE FL
32608-1136
US

IV. Provider business mailing address

833 PRINCETON AVENUE SW POB 3, SUITE 200-E
BIRMINGHAM AL
35211
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: