Provider Demographics
NPI:1659660546
Name:MID-FLORIDA AGE MANAGEMENT
Entity type:Organization
Organization Name:MID-FLORIDA AGE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-629-3311
Mailing Address - Street 1:1805 SE 16TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4672
Mailing Address - Country:US
Mailing Address - Phone:352-629-3311
Mailing Address - Fax:352-629-4311
Practice Address - Street 1:1805 SE 16TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4672
Practice Address - Country:US
Practice Address - Phone:352-629-3311
Practice Address - Fax:352-629-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care