Provider Demographics
NPI:1609903525
Name:OCALA REGIONAL PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:OCALA REGIONAL PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-732-8868
Mailing Address - Street 1:1190 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4510
Mailing Address - Country:US
Mailing Address - Phone:352-732-8868
Mailing Address - Fax:352-732-8890
Practice Address - Street 1:1708 CITRUS BLVD STE 5
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3467
Practice Address - Country:US
Practice Address - Phone:352-315-9006
Practice Address - Fax:352-315-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106819Medicare Oscar/Certification