Contract Details
Ancillary Care Services
Facility name
Clinical PET of Ocala
Provider ID
P000004546
NPI
1437389749
Tax ID
861093368
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
3233 Southwest 33rd Road Suite 301
Ocala, FL 34474
United States
County
Marion
Phone
3528614602 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address