Healthcare Provider Details

I. General information

NPI: 1740232438
Provider Name (Legal Business Name): BRIAN CHIVAS JAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD STE B
SARASOTA FL
34233-1207
US

IV. Provider business mailing address

3920 BEE RIDGE RD STE B
SARASOTA FL
34233-1207
US

V. Phone/Fax

Practice location:
  • Phone: 941-661-0515
  • Fax: 941-220-6599
Mailing address:
  • Phone: 941-661-0515
  • Fax: 941-220-6599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME68542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: