Healthcare Provider Details

I. General information

NPI: 1639682016
Provider Name (Legal Business Name): IDR MED FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 05/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6591 SW HIGHWAY 200
OCALA FL
34476-2033
US

IV. Provider business mailing address

3323 SW 115TH TER
GAINESVILLE FL
32608-0032
US

V. Phone/Fax

Practice location:
  • Phone: 352-236-6806
  • Fax: 352-622-2033
Mailing address:
  • Phone: 352-236-6806
  • Fax: 352-622-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JAVIER B CAIRO-LAVADO
Title or Position: OWNER
Credential: MD
Phone: 352-236-6806