Organization
INFECTIOUS DISEASES SPECIALTY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTENEH M. ADDISU MP, PHD (PRESIDENT)
(352) 362-6104
Entity
Organization
Contact information
Practice address
150 SE 17TH ST STE 801, OCALA, FL 34471
(352) 362-6104
Mailing address
PO BOX 3716, OCALA, FL 34478-3716
(352) 362-6104
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME75316
FL
Other
Enumeration date
05/18/2018
Last updated
08/24/2018
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