Healthcare Provider Details

I. General information

NPI: 1215490537
Provider Name (Legal Business Name): OCALA HOPE MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 SW 34TH CIR STE 301
OCALA FL
34474-6615
US

IV. Provider business mailing address

2911 SE 23RD AVE
OCALA FL
34471-6185
US

V. Phone/Fax

Practice location:
  • Phone: 352-216-5493
  • Fax:
Mailing address:
  • Phone: 352-216-5493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. BERNADETTE PARAISO
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-216-5493