Healthcare Provider Details

I. General information

NPI: 1609953942
Provider Name (Legal Business Name): ENDOSCOPY CENTER OF OCALA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SE 18TH AVE BUILDING #400
OCALA FL
34471-8215
US

IV. Provider business mailing address

1901 SE 18TH AVE BUILDING #400
OCALA FL
34471-8215
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-8905
  • Fax: 352-732-2440
Mailing address:
  • Phone: 352-732-8905
  • Fax: 352-732-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM EMERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-671-3882