Healthcare Provider Details

I. General information

NPI: 1295710317
Provider Name (Legal Business Name): CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3256 S PINE AVE
OCALA FL
34471-6618
US

IV. Provider business mailing address

3256 S PINE AVE
OCALA FL
34471-6618
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-1919
  • Fax: 352-401-1870
Mailing address:
  • Phone: 352-401-1919
  • Fax: 352-401-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1183
License Number StateFL

VIII. Authorized Official

Name: DR. VISHNU P REDDY
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 352-401-1919