Provider Demographics
NPI:1184706285
Name:UNIVERSITY OF FLORIDA
Entity type:Organization
Organization Name:UNIVERSITY OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FELLOW
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:JUDAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-392-2877
Mailing Address - Street 1:9634 NW 4TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6315
Mailing Address - Country:US
Mailing Address - Phone:352-392-2877
Mailing Address - Fax:
Practice Address - Street 1:9634 NW 4TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6315
Practice Address - Country:US
Practice Address - Phone:352-392-2877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6809OtherTRN