Healthcare Provider Details

I. General information

NPI: 1255891834
Provider Name (Legal Business Name): ALEXANDRE PHILIPPE MOKBEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7485 SW 17TH RD
GAINESVILLE FL
32607-1000
US

IV. Provider business mailing address

7485 SW 17TH RD
GAINESVILLE FL
32607-1000
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5700
  • Fax: 352-376-5975
Mailing address:
  • Phone: 352-333-5700
  • Fax: 352-376-4975

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 Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS19054
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: