Healthcare Provider Details

I. General information

NPI: 1457437188
Provider Name (Legal Business Name): CMS SARASOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6055 RAND BLVD
SARASOTA FL
34238-5189
US

IV. Provider business mailing address

6055 RAND BLVD
SARASOTA FL
34238-5189
US

V. Phone/Fax

Practice location:
  • Phone: 941-361-6250
  • Fax: 941-361-6272
Mailing address:
  • Phone: 941-361-6250
  • Fax: 941-361-6272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH HERRERA
Title or Position: REGIONAL PROGRAM ADMINISTRATOR
Credential: MBA
Phone: 941-361-6250