Provider Demographics
NPI:1659540524
Name:OCALA HEALTH SURGICAL GROUP LLC
Entity Type:Organization
Organization Name:OCALA HEALTH SURGICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:MEWSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-521-2117
Mailing Address - Street 1:4600 SW 46TH CT
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5708
Mailing Address - Country:US
Mailing Address - Phone:352-291-2400
Mailing Address - Fax:352-291-2405
Practice Address - Street 1:4600 SW 46TH CT
Practice Address - Street 2:SUITE 250
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5708
Practice Address - Country:US
Practice Address - Phone:352-291-2400
Practice Address - Fax:352-291-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP473Medicare PIN