Provider Demographics
NPI:1053409144
Name:PARES, SEGISMUNDO (MD)
Entity type:Individual
Prefix:
First Name:SEGISMUNDO
Middle Name:
Last Name:PARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 773176
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-3176
Mailing Address - Country:US
Mailing Address - Phone:352-873-3800
Mailing Address - Fax:352-873-4800
Practice Address - Street 1:1651 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1364
Practice Address - Country:US
Practice Address - Phone:352-873-3800
Practice Address - Fax:352-873-4800
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49835207QH0002X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061627300Medicaid
FL061627300Medicaid
FL04429ZMedicare PIN