Healthcare Provider Details

I. General information

NPI: 1891789269
Provider Name (Legal Business Name): OCALA SURGICAL CENTER ANESTHESIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3241 SW 34TH ST
OCALA FL
34474-7439
US

IV. Provider business mailing address

PO BOX 1626
OCALA FL
34478-1626
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-5906
  • Fax: 352-237-8758
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 NumberME86355
License Number StateFL

VIII. Authorized Official

Name: DR. JOE HERRERA
Title or Position: PRESIDENT
Credential: MD
Phone: 352-873-6808