Healthcare Provider Details

I. General information

NPI: 1861651259
Provider Name (Legal Business Name): MEDICAL MANAGEMENT OF OCALA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 SW 22ND PL
OCALA FL
34471-7765
US

IV. Provider business mailing address

2120 SW 22ND PL
OCALA FL
34471-7765
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-5042
  • Fax: 352-732-6031
Mailing address:
  • Phone: 352-732-5042
  • Fax: 352-732-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN PIZZUTI
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-732-5042