Healthcare Provider Details

I. General information

NPI: 1215167440
Provider Name (Legal Business Name): ALI ALSAMARAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALI YOUSEF ALSAMARAH

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US

IV. Provider business mailing address

1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-0288
  • Fax: 352-867-1053
Mailing address:
  • Phone: 352-369-0288
  • Fax: 352-867-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME151414
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number46022
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101284450
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME151414
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number266100
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: