Basic Information
| Provider Information | |||||||||
| NPI: | 1699259291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAJAFI | ||||||||
| FirstName: | GINA | ||||||||
| MiddleName: | LIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4812 NW 28TH PL | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326066088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522754822 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5611 SHELDON RD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336153532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133975300 | ||||||||
| FaxNumber: | 8134053709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2018 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DN23805 | FL | Y | Dental Providers | Dentist | General Practice |
No ID Information.