Healthcare Provider Details

I. General information

NPI: 1487810677
Provider Name (Legal Business Name): W. FREDERIC HARVEY, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3982 BEE RIDGE RD SUITE J
SARASOTA FL
34233-1210
US

IV. Provider business mailing address

3982 BEE RIDGE RD SUITE J
SARASOTA FL
34233-1210
US

V. Phone/Fax

Practice location:
  • Phone: 941-929-9355
  • Fax: 941-927-4914
Mailing address:
  • Phone: 941-929-9355
  • Fax: 941-927-4914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME49905
License Number StateFL

VIII. Authorized Official

Name: DR. W FREDERIC HARVEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 941-929-9355