Provider Demographics
NPI:1336635051
Name:ALWALIE, AMNA (DDS)
Entity Type:Individual
Prefix:
First Name:AMNA
Middle Name:
Last Name:ALWALIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 103628
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3628
Mailing Address - Country:US
Mailing Address - Phone:352-273-5971
Mailing Address - Fax:352-273-5985
Practice Address - Street 1:1329 SW 16TH ST RM 5180
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1128
Practice Address - Country:US
Practice Address - Phone:352-273-5971
Practice Address - Fax:352-273-5985
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program