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General NPI Number Information
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NPI Number | 1982879557
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Entity Type | Organization
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Legal Business Name | PAIN CARE OF OCALA, LLC
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 3301 SW 34TH CIR SUITE 203
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City | OCALA
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State | FL
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Zip | 34474-6621
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Country | US
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Telephone | 352-854-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 SW 34TH CIR SUITE 203
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City | OCALA
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State | FL
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Zip | 34474-6621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MRS. MARIA EUGENIA CORCORAN
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Credential |
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Telephone | 352-854-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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