Healthcare Provider Details

I. General information

NPI: 1275274508
Provider Name (Legal Business Name): MARCUS ANDREW NASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

148 COLONY POINT DR
PUNTA GORDA FL
33950-5030
US

V. Phone/Fax

Practice location:
  • Phone: 352-733-0111
  • Fax:
Mailing address:
  • Phone: 941-585-9464
  • Fax:

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 Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME172067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: