Healthcare Provider Details

I. General information

NPI: 1154350858
Provider Name (Legal Business Name): ALLCARE MEDICAL CENTERS, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5860 RANCH LAKE BLVD SUITE 200
BRADENTON FL
34202-3719
US

IV. Provider business mailing address

5860 RANCH LAKE BLVD SUITE 200
BRADENTON FL
34202-3718
US

V. Phone/Fax

Practice location:
  • Phone: 941-388-8997
  • Fax: 949-695-2987
Mailing address:
  • Phone: 941-388-8997
  • Fax: 949-695-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: KELLY LYNN NESSETTI-PRATHER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 941-388-8997