Healthcare Provider Details

I. General information

NPI: 1700718376
Provider Name (Legal Business Name): SIDE BY SIDE SENIOR SUPPORT L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WHITFIELD AVE
SARASOTA FL
34243-1529
US

IV. Provider business mailing address

333 WHITFIELD AVE
SARASOTA FL
34243-1529
US

V. Phone/Fax

Practice location:
  • Phone: 941-345-0004
  • Fax:
Mailing address:
  • Phone: 941-345-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DEIDRIA WILSON
Title or Position: OWNER
Credential:
Phone: 941-345-0004