Healthcare Provider Details

I. General information

NPI: 1477722841
Provider Name (Legal Business Name): SURGICAL CONSULTANTS OF CENTRAL FL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 SE 25TH LOOP SUITE 102
OCALA FL
34471
US

IV. Provider business mailing address

PO BOX 6195
OCALA FL
34478
US

V. Phone/Fax

Practice location:
  • Phone: 352-690-6000
  • Fax: 352-690-6643
Mailing address:
  • Phone: 352-690-6000
  • Fax: 352-690-6643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME85455
License Number StateFL

VIII. Authorized Official

Name: CHRISTIAN O ORAEDU
Title or Position: CEO
Credential: MD
Phone: 352-690-6000