Organization
ANTENEH ADDISU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTENEH ADDISU MD (OWNER)
(352) 362-6104
Entity
Organization
Contact information
Practice address
1431 SW 1ST AVE, OCALA, FL 34471-6500
(352) 632-6104
(352) 861-4702
Mailing address
PO BOX 3716, OCALA, FL 34478-3716
(352) 632-6104
(352) 861-4702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME75316
FL
Other
Enumeration date
08/31/2006
Last updated
04/20/2008
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