Healthcare Provider Details

I. General information

NPI: 1710968938
Provider Name (Legal Business Name): OCALA REGIONAL PHYSICAL THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 SE MARICAMP RD
OCALA FL
34471-5582
US

IV. Provider business mailing address

2620 SE MARICAMP RD
OCALA FL
34471-5582
US

V. Phone/Fax

Practice location:
  • Phone: 352-351-8883
  • Fax: 352-351-4219
Mailing address:
  • Phone: 352-732-8868
  • Fax: 352-732-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: WANDA NABBEFELD
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 352-732-8868