Healthcare Provider Details

I. General information

NPI: 1669038865
Provider Name (Legal Business Name): AHMED LABABIDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

6856 AXIS WEST CIR APT 3402
ORLANDO FL
32821-6109
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8234
  • Fax:
Mailing address:
  • Phone: 407-334-7396
  • 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 Code208000000X
TaxonomyPediatrics Physician
License NumberME156439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: