Healthcare Provider Details

I. General information

NPI: 1235502113
Provider Name (Legal Business Name): OCALA PSYCHIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SW 12TH ST
OCALA FL
34471-6518
US

IV. Provider business mailing address

2 SW 12TH ST
OCALA FL
34471-6518
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-4350
  • Fax: 352-629-3070
Mailing address:
  • Phone: 352-629-4350
  • Fax: 352-629-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS81
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH1421
License Number StateFL

VIII. Authorized Official

Name: DR. TIMOTHY BYRD
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 352-629-4350