Healthcare Provider Details

I. General information

NPI: 1417087313
Provider Name (Legal Business Name): RONALD FOX MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 SW 1ST AVE
OCALA FL
34471-0921
US

IV. Provider business mailing address

1056 SW 1ST AVE
OCALA FL
34471-0921
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-6766
  • Fax: 352-732-6718
Mailing address:
  • Phone: 352-732-6766
  • Fax: 352-732-6718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberME 12278
License Number StateFL

VIII. Authorized Official

Name: DR. IRA RONALD FOX
Title or Position: PRESIDENT
Credential: M.D.
Phone: 352-732-6766