Healthcare Provider Details

I. General information

NPI: 1972280907
Provider Name (Legal Business Name): SHAIMA SAMEER MOHIE DEEN BATAINEH MBBCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

5375 N 9TH AVE
PENSACOLA FL
32504-8725
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9011
  • Fax:
Mailing address:
  • Phone: 850-941-7841
  • Fax: 850-332-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN38658
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: