Provider Demographics
NPI:1104937382
Name:OCALA MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:OCALA MEDICAL ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CLEMENT
Authorized Official - Last Name:MANN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-351-0060
Mailing Address - Street 1:1500 SE 17TH STREET BLDG 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-351-0060
Mailing Address - Fax:352-351-4130
Practice Address - Street 1:1500 SE 17TH STREET BLDG 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-351-0060
Practice Address - Fax:352-351-4130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty