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General NPI Number Information
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NPI Number | 1457546897
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PARKWAY MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 3231 GULF GATE DR SUITE #101
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City | SARASOTA
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State | FL
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Zip | 34231-2406
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Country | US
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Telephone | 941-922-2340
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Fax | 941-922-2081
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Provider Business Mailing Address
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Address Line | 3231 GULF GATE DR SUITE #101
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City | SARASOTA
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State | FL
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Zip | 34231-2406
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Country | US
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Telephone | 941-922-2340
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Fax | 941-922-2081
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUHAIL A KHOURY
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Credential | PH.D., M.D.
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Telephone | 941-922-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0055732
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License Number State | FL
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