Healthcare Provider Details

I. General information

NPI: 1053409144
Provider Name (Legal Business Name): SEGISMUNDO PARES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 SW 42ND ST
OCALA FL
34471-1364
US

IV. Provider business mailing address

PO BOX 773176
OCALA FL
34477-3176
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-3800
  • Fax: 352-873-4800
Mailing address:
  • Phone: 352-873-3800
  • Fax: 352-873-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME49835
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME49835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: