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General NPI Number Information
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NPI Number | 1619412699
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Entity Type | Organization
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Legal Business Name | UMS LITHOTRIPSY SERVICES OF SARASOTA, LLC
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1 S SCHOOL AVE STE 103
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City | SARASOTA
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State | FL
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Zip | 34237-6047
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Country | US
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Telephone | 508-870-6565
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Fax | 508-870-0682
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Provider Business Mailing Address
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Address Line | 1700 W PARK DR STE 410
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City | WESTBOROUGH
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State | MA
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Zip | 01581-3939
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Country | US
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Telephone | 508-870-6565
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Fax | 508-870-0682
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SUSANNE TALEBIAN
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Credential |
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Telephone | 703-955-4923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QL0400X
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Taxonomy Name | Lithotripsy Clinic/Center
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License Number |
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License Number State |
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