Healthcare Provider Details

I. General information

NPI: 1760801815
Provider Name (Legal Business Name): POUYA ALEXANDER AMELI M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: POUYA ABDOLLAHZADEH

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UF NEUROLOGY MCKNIGHT BRAIN INSTITUTE 1149 NEWELL DRIVE
GAINESVILLE FL
32610-0001
US

IV. Provider business mailing address

PO BOX 100236
GAINESVILLE FL
32610-0236
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5550
  • Fax:
Mailing address:
  • Phone: 352-273-5550
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number079928
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME145264
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberME145264
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: