Provider Demographics
NPI:1285265090
Name:AMERICAN HEALTH MSO OF OCALA LLC
Entity type:Organization
Organization Name:AMERICAN HEALTH MSO OF OCALA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAYANTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-854-7444
Mailing Address - Street 1:2654 SW 32ND PL STE 100
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7847
Mailing Address - Country:US
Mailing Address - Phone:352-854-7444
Mailing Address - Fax:352-873-6647
Practice Address - Street 1:2654 SW 32ND PL STE 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7847
Practice Address - Country:US
Practice Address - Phone:352-854-7444
Practice Address - Fax:352-873-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty