Healthcare Provider Details

I. General information

NPI: 1487335055
Provider Name (Legal Business Name): OCALA CARDIOVASCULAR INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 SE LAKE WEIR AVE
OCALA FL
34471
US

IV. Provider business mailing address

1202 SW 17TH ST STE 201
OCALA FL
34471-1283
US

V. Phone/Fax

Practice location:
  • Phone: 352-362-4223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ASAD QAMAR
Title or Position: SOLE MEMBER/OWNER
Credential: MD
Phone: 352-804-4049