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General NPI Number Information
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NPI Number | 1457387888
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Entity Type | Individual
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Provider Name | ALI NASSER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 8550 NE 138TH LN STE 401
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City | LADY LAKE
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State | FL
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Zip | 32159
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Country | US
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Telephone | 352-347-2315
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Fax | 352-854-8192
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Provider Business Mailing Address
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Address Line | 8550 NE 138TH LN STE 401
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City | LADY LAKE
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State | FL
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Zip | 32159-8957
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Country | US
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Telephone | 352-347-2315
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Fax | 352-854-8192
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME83972
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License Number State | FL
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