Healthcare Provider Details

I. General information

NPI: 1427083021
Provider Name (Legal Business Name): SARASOTA PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S OSPREY AVE
SARASOTA FL
34239-3511
US

IV. Provider business mailing address

1700 S OSPREY AVE
SARASOTA FL
34239-3511
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-0624
  • Fax:
Mailing address:
  • Phone: 941-366-0624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KING
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 727-767-4755