Healthcare Provider Details

I. General information

NPI: 1053280800
Provider Name (Legal Business Name): COOLEY GEORGE PANTAZIS, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 SW COLLEGE RD
OCALA FL
34474-5713
US

IV. Provider business mailing address

PO BOX 743170
ATLANTA GA
30374-3170
US

V. Phone/Fax

Practice location:
  • Phone: 352-368-3443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: COOLEY G PANTAZIS
Title or Position: OWNER
Credential:
Phone: 800-831-2402