Tomer Keidan, MD MPH

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1515 SW Archer Rd
Gainesville, FL 32608-1134

Phone

(352) 265-0916

NPI assigned

May 3, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1508487307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SW 16TH CT",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081516",
            "telephone_number": "352-256-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081134",
            "telephone_number": "352-265-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIDAN",
        "first_name": "TOMER",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-03",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Catherine Keeley, MD
• Deborah Keen
• Christopher Charles Keglor, L.M.T.
• Pauline Pennell Kehoe, M. AC.
• Ilan Keidan, MD
• Codee Joseph Keighley
• Kahlie Meara Keim
• Bahareh Ebadifar Keith, DO
• Engeria Keith
• Mary C Keith, OTR

• Student in an Organized Health Care Education/Training Program in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.