Healthcare Provider Details

I. General information

NPI: 1285679894
Provider Name (Legal Business Name): LAKE COUNTY ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 SW 1ST AVE
OCALA FL
34471-6505
US

IV. Provider business mailing address

PO BOX 3130
OCALA FL
34478-3130
US

V. Phone/Fax

Practice location:
  • Phone: 352-867-0516
  • Fax: 352-867-5076
Mailing address:
  • Phone: 352-867-0516
  • Fax: 352-867-5076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENT C. PALMIRE JR.
Title or Position: PARTNER
Credential: M.D.
Phone: 352-867-8311