Provider Demographics
NPI:1801253513
Name:MINIMALLY INVASIVE SURGEONS OF OCALA, PLLC
Entity type:Organization
Organization Name:MINIMALLY INVASIVE SURGEONS OF OCALA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:CABAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-291-0239
Mailing Address - Street 1:4600 SW 46TH CT
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5708
Mailing Address - Country:US
Mailing Address - Phone:352-291-0239
Mailing Address - Fax:352-291-0254
Practice Address - Street 1:4600 SW 46TH CT
Practice Address - Street 2:SUITE 220
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5708
Practice Address - Country:US
Practice Address - Phone:352-291-0239
Practice Address - Fax:352-291-0254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107917208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty