Healthcare Provider Details

I. General information

NPI: 1629336680
Provider Name (Legal Business Name): BENJAMIN D COLVARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N CATTLEMEN RD STE 220
SARASOTA FL
34232-6422
US

IV. Provider business mailing address

600 N CATTLEMEN RD STE 220
SARASOTA FL
34232-6422
US

V. Phone/Fax

Practice location:
  • Phone: 941-371-6565
  • Fax: 941-377-7731
Mailing address:
  • Phone: 941-371-6565
  • Fax: 941-377-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME180689
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: