Healthcare Provider Details

I. General information

NPI: 1952417370
Provider Name (Legal Business Name): OCALA CANCER INSTITUTE P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 SE 3RD CT SUITE 200
OCALA FL
34471
US

IV. Provider business mailing address

2820 SE 3RD CT SUITE 200
OCALA FL
34471
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-8111
  • Fax: 352-867-5134
Mailing address:
  • Phone: 352-732-8111
  • Fax: 352-867-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME0046963
License Number StateFL

VIII. Authorized Official

Name: MOHAMMAD K KAMAL
Title or Position: MD
Credential: MD
Phone: 352-732-8111