Healthcare Provider Details

I. General information

NPI: 1861895831
Provider Name (Legal Business Name): SUSHIL PUSKUR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SE 18TH ST STE 801B
OCALA FL
34471-5447
US

IV. Provider business mailing address

1740 SE 18TH ST STE 801B
OCALA FL
34471-5447
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-3100
  • Fax: 352-369-3101
Mailing address:
  • Phone: 352-369-3100
  • Fax: 352-369-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 99963
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME 99963
License Number StateFL

VIII. Authorized Official

Name: DR. SUSHIL PUSKUR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 352-369-3100