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General NPI Number Information
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NPI Number | 1013278662
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Entity Type | Organization
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Legal Business Name | SARASOTA MANATEE GERIATRICS LLC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 5120 CANTERBURY DR
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City | SARASOTA
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State | FL
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Zip | 34243-4705
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Country | US
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Telephone | 206-919-1593
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Fax |
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Provider Business Mailing Address
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Address Line | 8466 LOCKWOOD RIDGE RD NUM 160
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City | SARASOTA
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State | FL
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Zip | 34243-2951
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Country | US
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Telephone | 941-228-0270
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Fax | 941-460-5448
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Authorized Official
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Title or Position | ARNP
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Name | MRS. RENEE HOPE FLETCHER
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Credential | ARNP
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Telephone | 206-919-1593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | ARNP3186252
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License Number State | FL
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