Healthcare Provider Details

I. General information

NPI: 1306189527
Provider Name (Legal Business Name): NOHRA EL CHALOUHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-5211
US

IV. Provider business mailing address

PO BOX 100265
GAINESVILLE FL
32610-0265
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9000
  • Fax: 352-392-8413
Mailing address:
  • Phone: 352-273-9000
  • Fax: 352-392-8413

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 Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME143909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: