# JOHN A DRYFUSS JR MD PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JOHN A DRYFUSS JR MD PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215214259
- **Legal business name:** JOHN A DRYFUSS JR MD PA
- **Authorized official:** DR. JOHN A DRYFUSS JR. M.D. P.A. (PRESIDENT)
- **Authorized official phone:** (352) 331-1773

## Contact information

- **Practice address:** 7109 NW 11TH PL, STE C, GAINESVILLE, FL 32605-3170
- **Practice address phone:** (352) 331-1773
- **Practice address fax:** (352) 331-1814
- **Mailing address:** 7109 NW 11TH PL, STE C, GAINESVILLE, FL 32605-3170
- **Mailing address phone:** (352) 331-1773
- **Mailing address fax:** (352) 331-1814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME0015017 | FL | Yes |

## Other

- **Enumeration date:** 11/04/2011
- **Last updated:** 11/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0355799500 | — | FL |