MEDICARE: OAKS FAMILY PRACTICE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1477785509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKS FAMILY PRACTICE PA

Provider Business Mailing Address
First Line	:	8620 S TAMIAMI TRL
Second Line	:	SUITE F-G
City	:	SARASOTA
State	:	FL
Zip	:	34238-3049
Country	:	US
Telephone Number	:	941-966-4949
Fax Number	:

Provider Business Practice Location Address
First Line	:	8620 S TAMIAMI TRL
Second Line	:	SUITE F-G
City	:	SARASOTA
State	:	FL
Zip	:	34238-3049
Country	:	US
Telephone Number	:	941-966-4949
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE DIRECTOR
Name	:	MS. MARIE BRADY
Credential	:
Telephone Number	:	941-966-4949

Provider Enumeration Date	:	08/24/2009
Last Update Date	:	09/23/2013

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