Healthcare Provider Details
I. General information
NPI: 1659072999
Provider Name (Legal Business Name): PREMIER PHYSICIANS OF SARASOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1843 FLOYD ST
SARASOTA FL
34239-2937
US
IV. Provider business mailing address
1843 FLOYD ST
SARASOTA FL
34239-2937
US
V. Phone/Fax
- Phone: 941-951-3920
- Fax: 941-951-3922
- Phone: 941-951-3920
- Fax: 941-951-3922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREGORY
J.
FERREIRA
Title or Position: PARTNER
Credential: MD
Phone: 941-951-3920