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Individual

DR. IBRAHIM NASSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0535
(352) 627-4173
Mailing address
1600 SW ARCHER RD, BOX 100109, GAINESVILLE, FL 32610
(352) 265-0761
(352) 265-0190

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME150532
FL
2086X0206X
Surgical Oncology Physician
Primary
ME150532
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110945600
FL
Enumeration date
03/25/2012
Last updated
09/27/2023
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