Provider Demographics
NPI:1831481399
Name:ACKERMAN, PAULA DIANE (DO)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:DIANE
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:DIANE
Other - Last Name:ACKERMAN-KIBBEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3450 HULL RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4144
Mailing Address - Country:US
Mailing Address - Phone:352-627-7671
Mailing Address - Fax:
Practice Address - Street 1:2708 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1316
Practice Address - Country:US
Practice Address - Phone:352-554-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63044208100000X
OH34.011980208100000X
KY04470208100000X
FLOS18893208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation