Individual
RAED AL YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 294-8278
(352) 265-0379
Mailing address
462 GRIDER ST., ECMC, BUFFALO, NY 14213
(716) 898-4226
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME139692
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME139692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104002700
—
FL
Enumeration date
05/07/2015
Last updated
01/13/2025
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