Healthcare Provider Details

I. General information

NPI: 1902081730
Provider Name (Legal Business Name): SANDRA CHECCA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N TAMIAMI TRL #407
SARASOTA FL
34236-4054
US

IV. Provider business mailing address

800 N TAMIAMI TRL #407
SARASOTA FL
34236-4054
US

V. Phone/Fax

Practice location:
  • Phone: 941-932-2243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA CHECCA
Title or Position: SOLE MBR
Credential: MD
Phone: 941-932-2243