Healthcare Provider Details

I. General information

NPI: 1558557249
Provider Name (Legal Business Name): OCALA FAMILY PHYSICIANS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 SE 17TH ST STE 100
OCALA FL
34471-5586
US

IV. Provider business mailing address

3515 SE 17TH ST STE 100
OCALA FL
34471-5586
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-9922
  • Fax: 352-732-6934
Mailing address:
  • Phone: 352-732-9922
  • Fax: 352-732-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME50997
License Number StateFL

VIII. Authorized Official

Name: DR. GLEN ANDREW MORGAN
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 352-732-9922