Healthcare Provider Details
I. General information
NPI: 1023992625
Provider Name (Legal Business Name): GREATER OCALA ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17355 SE 109TH TERRACE RD
SUMMERFIELD FL
34491-8930
US
IV. Provider business mailing address
PO BOX 739626
DALLAS TX
75373-9626
US
V. Phone/Fax
- Phone: 352-261-0499
- Fax:
- Phone: 800-959-5509
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
THOMAS
KREGER
Title or Position: CEO
Credential:
Phone: 502-418-4700