Provider Demographics
NPI:1548424328
Name:SHAND'S HOSPITAL OF UF
Entity Type:Organization
Organization Name:SHAND'S HOSPITAL OF UF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:OTHMAN
Authorized Official - Last Name:SHEMISA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-642-2828
Mailing Address - Street 1:900 SW 62ND BLVD
Mailing Address - Street 2:H-46
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 SW 62ND BLVD
Practice Address - Street 2:H-46
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5918
Practice Address - Country:US
Practice Address - Phone:352-642-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251V00000X
FL12588282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No251V00000XAgenciesVoluntary or Charitable