Healthcare Provider Details
I. General information
NPI: 1104810324
Provider Name (Legal Business Name): TRUE CARE MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1623 SW 1ST AVE
OCALA FL
34474-4028
US
IV. Provider business mailing address
1623 SW 1ST AVE
OCALA FL
34474-4028
US
V. Phone/Fax
- Phone: 352-732-9844
- Fax: 352-732-6787
- Phone: 352-732-9844
- Fax: 352-732-6787
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KUCHAKULLA
N
REDDY
Title or Position: PRESIDENT
Credential: M. D.
Phone: 352-732-9844