Provider Demographics
NPI:1689966889
Name:CLINICAL PET OF OCALA LLC
Entity Type:Organization
Organization Name:CLINICAL PET OF OCALA LLC
Other - Org Name:RADIOLOGICAL INSTITUTE OF OCALA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:D
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:352-291-0014
Mailing Address - Street 1:PO BOX 773029
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-3029
Mailing Address - Country:US
Mailing Address - Phone:352-629-7029
Mailing Address - Fax:352-690-7023
Practice Address - Street 1:1609 SW 17TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1224
Practice Address - Country:US
Practice Address - Phone:352-629-7029
Practice Address - Fax:352-690-7023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME35747OtherMEDICAL DIRECTOR LICENSE