Organization
OCALA INFECTIOUS DISEASE AND WOUND CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARIS INAM MIRZA M.D. (PRESIDENT)
(352) 401-7552
Entity
Organization
Contact information
Practice address
321 SE 29TH PL, SUITE 101, OCALA, FL 34471-0489
(352) 401-7552
(352) 622-7945
Mailing address
PO BOX 5580, OCALA, FL 34478-5580
(352) 401-7552
(352) 622-7945
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME88195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267672900
—
FL
01
—
K8951
MEDICARE PTAN
—
Enumeration date
06/26/2007
Last updated
03/07/2014
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