Healthcare Provider Details

I. General information

NPI: 1336070572
Provider Name (Legal Business Name): CARESOLA MEDICAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 NORTHGATE BLVD STE 116
SARASOTA FL
34234-2143
US

IV. Provider business mailing address

1903 NORTHGATE BLVD STE 116
SARASOTA FL
34234-2143
US

V. Phone/Fax

Practice location:
  • Phone: 941-315-9429
  • Fax: 941-315-9439
Mailing address:
  • Phone: 941-315-9429
  • Fax: 941-315-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM RYAN INCE
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 650-798-9039