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General NPI Number Information
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NPI Number | 1659540524
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Entity Type | Organization
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Legal Business Name | OCALA HEALTH SURGICAL GROUP LLC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 4600 SW 46TH CT SUITE 250
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City | OCALA
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State | FL
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Zip | 34474-5708
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Country | US
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Telephone | 352-291-2400
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Fax | 352-291-2405
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Provider Business Mailing Address
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Address Line | 4600 SW 46TH CT SUITE 250
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City | OCALA
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State | FL
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Zip | 34474-5708
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Country | US
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Telephone | 352-291-2400
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Fax | 352-291-2405
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Authorized Official
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Title or Position | VP
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Name | CHUCK MEWSHAW
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Credential |
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Telephone | 850-521-2117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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License Number State |
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