Healthcare Provider Details

I. General information

NPI: 1316450190
Provider Name (Legal Business Name): AARON CARLTON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 ARLINGTON ST STE 310
SARASOTA FL
34239
US

IV. Provider business mailing address

PO BOX 863407
ORLANDO FL
32886-3407
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-6300
  • Fax: 941-917-6306
Mailing address:
  • Phone: 941-917-2600
  • Fax: 941-917-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9110883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: