Basic Information
Provider Information
NPI: 1306189527
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EL CHALOUHI
FirstName: NOHRA
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: PO BOX 100265
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326100265
CountryCode: US
TelephoneNumber: 3522739000
FaxNumber: 3523928413
Practice Location
Address1: 1600 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326105211
CountryCode: US
TelephoneNumber: 3522739000
FaxNumber: 3523928413
Other Information
ProviderEnumerationDate: 04/05/2013
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207T00000XME143909FLY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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