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General NPI Number Information
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NPI Number | 1578601464
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Entity Type | Organization
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Legal Business Name | OCALA PEDIATRICS LLC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1500 SE 17TH ST #600
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City | OCALA
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State | FL
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Zip | 34471-4621
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Country | US
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Telephone | 352-732-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 SE 17TH ST #600
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City | OCALA
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State | FL
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Zip | 34471-4621
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Country | US
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Telephone | 352-732-8955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL C LOGAS
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Credential | MD
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Telephone | 352-732-8955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | FL
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