Provider Demographics
NPI:1194398115
Name:OCALA KIDNEY GROUP INC
Entity Type:Organization
Organization Name:OCALA KIDNEY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-622-4231
Mailing Address - Street 1:2980 SE 3RD CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0421
Mailing Address - Country:US
Mailing Address - Phone:352-622-4231
Mailing Address - Fax:352-622-0518
Practice Address - Street 1:6520 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4205
Practice Address - Country:US
Practice Address - Phone:352-745-7202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty