Ocala Medical and Infectious Disease Associates PA
Organization Active NPI Infectious Disease Physician · Ocala, FL
NPI 1821491895 · NPPES record last updated Mar 12, 2015
Key facts
- NPI
- 1821491895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- Legal business name
- OCALA MEDICAL AND INFECTIOUS DISEASE ASSOCIATES PA
- Practice address
- 3306 SW 26TH Ave
Ste 104
Ocala, FL 34471-7856 - Phone
- (352) 622-2020
- Fax
- (352) 622-2025
- NPI assigned
- Oct 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Ivan I Soosaipillai, M.D.
- Title
- Owner
- Phone
- (352) 622-2020
Practitioners 13
-
Brandi Lee Bowers, APRN
-
Pamela Corkern, ARNP
-
Tanya Marie Johnson, ARNP
-
Leamarie Lord, FNP
-
Rikki Lee Anna McCroskey, APRN
-
Tabitha Lanee Newborn, ARNP
-
Teresa Dawn Russell, APRN
-
Suzy A Schmeltz, P.A.C.
-
Maria Shirley, APRN, FNP-C
-
Lauren Rae Stringer, APRN
National Provider Directory
Locations
3306 SW 26th Ave
Ste 104
Ocala, FL 34471
Phone (352) 622-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | Yes |
Addresses
Primary practice location
3306 SW 26TH Ave
Ste 104
Ocala, FL 34471-7856
Mailing address
3306 SW 26TH Ave
Ste 104
Ocala, FL 34471-7856
Phone (352) 622-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013502700 | Medicaid | FL | |
| 008N8 | Other | FL | BCBS OF FLORIDA |
NPI Registry JSON
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426118400000",
"number": "1821491895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3306 SW 26TH AVE",
"address_2": "STE 104",
"city": "OCALA",
"state": "FL",
"postal_code": "344717856",
"telephone_number": "352-622-2020",
"fax_number": "352-622-2025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3306 SW 26TH AVE",
"address_2": "STE 104",
"city": "OCALA",
"state": "FL",
"postal_code": "344717856",
"telephone_number": "352-622-2020",
"fax_number": "352-622-2025"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OCALA MEDICAL AND INFECTIOUS DISEASE ASSOCIATES PA",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-03",
"last_updated": "2015-03-12",
"status": "A",
"authorized_official_last_name": "SOOSAIPILLAI",
"authorized_official_first_name": "IVAN",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "352-622-2020",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "013502700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FLORIDA",
"identifier": "008N8",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
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All providers in Ocala, FL · Infectious Disease Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.