Organization
VANTAGE HEALTH, LLC
Active
Other names
Vantage Urologic Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD RUSSELL LOCKE MD (MANAGING MEMBER)
(352) 861-2115
Entity
Organization
Contact information
Practice address
9401 SW HIGHWAY 200 STE 502, OCALA, FL 34481-9650
(352) 671-4488
(352) 854-5726
Mailing address
PO BOX 773730, OCALA, FL 34477-3730
(352) 861-2115
(352) 854-5726
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
12/17/2009
Last updated
05/08/2018
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