Healthcare Provider Details

I. General information

NPI: 1700690625
Provider Name (Legal Business Name): GHIDA LAWAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR. GAINESVILLE, FL 32610
GAINESVILLE FL
32610-0416
US

IV. Provider business mailing address

1395 CENTER DR GAINESVILLE FL 32610
GAINESVILLE FL
32610-0416
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6750
  • Fax: 352-392-7609
Mailing address:
  • Phone: 352-273-6750
  • Fax: 352-392-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDRPM2828
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: