Healthcare Provider Details

I. General information

NPI: 1801007448
Provider Name (Legal Business Name): OCALA NEURODIAGNOSTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SE 18TH AVE BLDG 400
OCALA FL
34471-8215
US

IV. Provider business mailing address

PO BOX 6480
OCALA FL
34478-6480
US

V. Phone/Fax

Practice location:
  • Phone: 352-598-4330
  • Fax: 352-694-6848
Mailing address:
  • Phone: 352-598-4330
  • Fax: 352-694-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY JACK HOWELL
Title or Position: PARTNER
Credential: MD
Phone: 352-598-4330