Healthcare Provider Details

I. General information

NPI: 1649535063
Provider Name (Legal Business Name): LOURDES L VARELA-BATISTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 SW 19TH AVENUE RD STE 103
OCALA FL
34471-7877
US

IV. Provider business mailing address

2230 SW 19TH AVENUE RD
OCALA FL
34471-1391
US

V. Phone/Fax

Practice location:
  • Phone: 352-368-1340
  • Fax: 352-237-7728
Mailing address:
  • Phone: 352-237-4133
  • Fax: 352-237-7728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME127468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: