Healthcare Provider Details

I. General information

NPI: 1437316437
Provider Name (Legal Business Name): PEDIATRIC ASSOCIATES OF OCALA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S.E. MARICAMP ROAD
OCALA FL
34471
US

IV. Provider business mailing address

2725 SE MARICAMP ROAD
OCALA FL
34471
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-8700
  • Fax: 352-369-8703
Mailing address:
  • Phone: 352-369-8700
  • Fax: 352-369-8703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE H. KRAUT
Title or Position: OWNER
Credential: M.D.
Phone: 352-369-8700