MEDICARE: OLIVE BRANCH MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1427844869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE BRANCH MEDICAL LLC

Provider Business Mailing Address
First Line	:	35 SE 1ST AVE STE 200F
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	352-234-3334
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 SE 1ST AVE STE 200
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	352-234-3334
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	JULIE CRUSE
Credential	:	APRN
Telephone Number	:	352-234-3332

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	10/22/2025

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Directions to “OLIVE BRANCH MEDICAL LLC ” Practice Location

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