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General NPI Number Information
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NPI Number | 1104937382
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Entity Type | Organization
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Legal Business Name | OCALA MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 1500 SE 17TH STREET BLDG 200
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-351-0060
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Fax | 352-351-4130
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Provider Business Mailing Address
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Address Line | 1500 SE 17TH STREET BLDG 200
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-351-0060
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Fax | 352-351-4130
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD CLEMENT MANN JR.
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Credential | MD
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Telephone | 352-351-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State | FL
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