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General NPI Number Information
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NPI Number | 1780989483
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Entity Type | Organization
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Legal Business Name | SARASOTA MEDICAL CARE PA
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 3530 FRUITVILLE RD
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City | SARASOTA
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State | FL
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Zip | 34237-9026
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Country | US
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Telephone | 941-552-8808
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Fax | 941-552-8805
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Provider Business Mailing Address
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Address Line | PO BOX 3558
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City | SARASOTA
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State | FL
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Zip | 34230-3558
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Country | US
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Telephone | 941-552-8808
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Fax | 941-552-8805
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Authorized Official
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Title or Position | OWNER
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Name | WELLINGTON CHEN
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Credential | M.D.
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Telephone | 941-552-8808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME30555
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License Number State | FL
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