=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730423963
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOCTORS HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2012
-----------------------------------------------------
Last Update Date | 11/09/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5731 BEE RIDGE RD
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-5056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-539-1362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1436 DONA WAY
-----------------------------------------------------
City | NOKOMIS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34275-2368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-539-1362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ARNP
-----------------------------------------------------
Name | MRS. LEAH BISHOP
-----------------------------------------------------
Credential | RN, FNP-C
-----------------------------------------------------
Telephone | 941-539-1362
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number | RN9216861
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------