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General NPI Number Information
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NPI Number | 1730239583
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Entity Type | Organization
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Legal Business Name | WESTSIDE MEDICAL CARE, INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2225 59TH ST W STE B
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City | BRADENTON
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State | FL
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Zip | 34209-7006
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Country | US
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Telephone | 941-792-1412
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Fax | 941-795-0753
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Provider Business Mailing Address
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Address Line | 2225 59TH ST W STE B
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City | BRADENTON
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State | FL
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Zip | 34209-7006
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Country | US
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Telephone | 941-792-1412
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Fax | 941-795-0753
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PAMELA A PERRY
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Credential |
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Telephone | 941-792-1412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 24084
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME71117
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License Number State | FL
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