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General NPI Number Information
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NPI Number | 1427253707
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Entity Type | Organization
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Legal Business Name | CLINICAL PET OF OCALA LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 11950 COUNTY ROAD 101
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City | THE VILLAGES
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State | FL
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Zip | 32162-9332
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Country | US
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Telephone | 352-391-6190
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Fax | 352-391-6199
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Provider Business Mailing Address
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Address Line | PO BOX 773029
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City | OCALA
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State | FL
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Zip | 34477-3029
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Country | US
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Telephone | 352-391-6190
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Fax | 352-391-6199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GANESH ARORA
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Credential | PHD
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Telephone | 352-291-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | HCC7959
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License Number State | FL
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