Healthcare Provider Details

I. General information

NPI: 1649043399
Provider Name (Legal Business Name): OCALA EYE SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 COUNTY ROAD 507
WILDWOOD FL
34785-7845
US

IV. Provider business mailing address

3330 SW 33RD RD
OCALA FL
34474-7458
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-9311
  • Fax: 352-873-9652
Mailing address:
  • Phone: 352-873-9311
  • Fax: 352-873-9652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANN T HOTALING
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 352-873-9311