Provider Demographics
NPI:1306905948
Name:OCALA HAND CENTER, LLC
Entity type:Organization
Organization Name:OCALA HAND CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-369-1099
Mailing Address - Street 1:PO BOX 9074
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9074
Mailing Address - Country:US
Mailing Address - Phone:352-369-1099
Mailing Address - Fax:352-369-0299
Practice Address - Street 1:2640 SW 32ND PLACE
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:352-369-1099
Practice Address - Fax:352-369-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9535207XS0106X
FLPO3280213E00000X
FLOS9484207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL56088OtherBCBS
FLP00442268OtherMEDICARE RR PTAN
FL16973OtherBCBS
FL24419OtherBCBS GROUP
FL276069000Medicaid
FLDG5713OtherMEDICARE RR GROUP
FLI66326Medicare UPIN
FL276069000Medicaid
FL5929150001Medicare NSC