Healthcare Provider Details

I. General information

NPI: 1366866691
Provider Name (Legal Business Name): MARION SURGERY CENTER ANESTHESIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 S PINE AVE SUITE A
OCALA FL
34471-5102
US

IV. Provider business mailing address

PO BOX 1626
OCALA FL
34478-1626
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-6808
  • Fax: 352-873-9726
Mailing address:
  • Phone: 352-873-6808
  • Fax: 352-873-9726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME40627
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN THOMAS PYLES
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 352-873-6808