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General NPI Number Information
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NPI Number | 1215144191
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALISTS OF OCALA PA
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 1920 SW 20TH PLACE BUILDING 100
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City | OCALA
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State | FL
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Zip | 34471-7881
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Country | US
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Telephone | 352-237-1212
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Fax | 352-237-0066
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Provider Business Mailing Address
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Address Line | 1920 SW 20TH PLACE BUILDING 100
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City | OCALA
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State | FL
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Zip | 34471-7881
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Country | US
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Telephone | 352-237-1212
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Fax | 352-237-0066
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Authorized Official
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Title or Position | BUSINES MANAGER
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Name | TERESA BARUP
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Credential |
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Telephone | 352-237-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME59502
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME59502
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME59502
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License Number State | FL
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