Healthcare Provider Details
I. General information
NPI: 1922065705
Provider Name (Legal Business Name): BURNS PRCHAL MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
127 SW 11TH ST
OCALA FL
34478
US
IV. Provider business mailing address
PO B 4045
OCALA FL
34478
US
V. Phone/Fax
- Phone: 352-351-8600
- Fax:
- Phone: 352-351-8600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEE
PRCHAL
Title or Position: SOLE PROPRIETOR
Credential: MD
Phone: 352-351-8600