Healthcare Provider Details

I. General information

NPI: 1093700874
Provider Name (Legal Business Name): MANORANJAN P SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 SE LAKE WEIR AVE
OCALA FL
34471-5426
US

IV. Provider business mailing address

1805 SE LAKE WEIR AVE
OCALA FL
34471-5426
US

V. Phone/Fax

Practice location:
  • Phone: 352-867-9600
  • Fax: 352-867-9603
Mailing address:
  • Phone: 352-867-9600
  • Fax: 352-867-9603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0049864
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number49864
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number49864
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: