Healthcare Provider Details

I. General information

NPI: 1871711648
Provider Name (Legal Business Name): MARION RADIOLOGY CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 SE 14TH ST
OCALA FL
34471-4711
US

IV. Provider business mailing address

2627 SE 14TH ST
OCALA FL
34471-4711
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License NumberOS1733
License Number StateFL

VIII. Authorized Official

Name: SHELDON L KATANICK
Title or Position: PRESIDENT
Credential: D.O.
Phone: 352-237-4133