Healthcare Provider Details

I. General information

NPI: 1144287889
Provider Name (Legal Business Name): ELIZABETH ANNE REISINGER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 CLARK RD STE 101
SARASOTA FL
34231-8400
US

IV. Provider business mailing address

5600 BEE RIDGE RD STE C
SARASOTA FL
34233-1500
US

V. Phone/Fax

Practice location:
  • Phone: 941-921-4131
  • Fax: 941-921-4173
Mailing address:
  • Phone: 941-312-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS7551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: