Basic Information
Provider Information
NPI: 1104810324
EntityType: 2
ReplacementNPI:  
OrganizationName: TRUE CARE MEDICAL ASSOCIATES, PA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1623 SW 1ST AVE
Address2:  
City: OCALA
State: FL
PostalCode: 344744028
CountryCode: US
TelephoneNumber: 3527329844
FaxNumber: 3527326787
Practice Location
Address1: 1623 SW 1ST AVE
Address2:  
City: OCALA
State: FL
PostalCode: 344744028
CountryCode: US
TelephoneNumber: 3527329844
FaxNumber: 3527326787
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: REDDY
AuthorizedOfficialFirstName: KUCHAKULLA
AuthorizedOfficialMiddleName: N
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3527329844
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M. D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  Y193400000X SINGLE SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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