1770124000 NPI number — ACCESS-PT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770124000 NPI number — ACCESS-PT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS-PT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770124000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7651 SW HIGHWAY 200 STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34476-7727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-992-2039
Provider Business Mailing Address Fax Number:
727-868-3838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7651 SW HIGHWAY 200 STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34476-7727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-992-2039
Provider Business Practice Location Address Fax Number:
727-868-3838
Provider Enumeration Date:
10/08/2019

Additional Information

Authorized Official

Authorized Official Last Name:
OUANO
Authorized Official First Name:
MAY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
727-992-2039

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PT773 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 104472700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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