Healthcare Provider Details

I. General information

NPI: 1609700293
Provider Name (Legal Business Name): IMPHYS SPECIALIST CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5611 SW 34TH ST
OCALA FL
34474-9468
US

IV. Provider business mailing address

5611 SW 34TH ST
OCALA FL
34474-9468
US

V. Phone/Fax

Practice location:
  • Phone: 352-410-4465
  • Fax:
Mailing address:
  • Phone: 352-410-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORGE RUIZ LLANES
Title or Position: PRESIDENT
Credential: MD
Phone: 352-410-4465