Healthcare Provider Details

I. General information

NPI: 1093948556
Provider Name (Legal Business Name): OCALA ONCOLOGY CENTER PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13940 US HWY 441 N. SUITE 203
LADY LAKE FL
32159-8909
US

IV. Provider business mailing address

7324 LITTLE RD
NEW PORT RICHEY FL
34654-5518
US

V. Phone/Fax

Practice location:
  • Phone: 352-259-8940
  • Fax: 352-430-1073
Mailing address:
  • Phone: 727-484-7722
  • Fax: 727-484-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAMA BALARAMAN
Title or Position: PRACTICE PRESIDENT
Credential: M.D.
Phone: 352-732-4032