1093948556 NPI number — OCALA ONCOLOGY CENTER PL

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 1093948556 NPI number — OCALA ONCOLOGY CENTER PL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCALA ONCOLOGY CENTER PL
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:
6
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:
1093948556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7324 LITTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PORT RICHEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34654-5518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-484-7722
Provider Business Mailing Address Fax Number:
727-484-7781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13940 US HWY 441 N.
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
LADY LAKE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32159-8909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-259-8940
Provider Business Practice Location Address Fax Number:
352-430-1073
Provider Enumeration Date:
09/01/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BALARAMAN
Authorized Official First Name:
RAMA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE PRESIDENT
Authorized Official Telephone Number:
352-732-4032

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 265199802 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: DP5758 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com