Healthcare Provider Details

I. General information

NPI: 1538764014
Provider Name (Legal Business Name): OCALA REGIONAL PHYSICAL THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 S MAIN ST STE C
WILLISTON FL
32696-2681
US

IV. Provider business mailing address

2620 SE MARICAMP RD
OCALA FL
34471-5582
US

V. Phone/Fax

Practice location:
  • Phone: 352-528-0022
  • Fax: 352-528-2878
Mailing address:
  • Phone: 352-732-8868
  • Fax: 352-732-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

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