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General NPI Number Information
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NPI Number | 1982638730
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Entity Type | Organization
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Legal Business Name | SUNCOAST ORTHOPAEDIC SURGERY & SPORTS MEDICINE, P.A.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 3030 EXECUTIVE DR
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City | VENICE
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State | FL
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Zip | 34292-2613
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Country | US
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Telephone | 941-485-1505
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Fax | 941-492-4065
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Provider Business Mailing Address
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Address Line | 3030 EXECUTIVE DR
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City | VENICE
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State | FL
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Zip | 34292-2613
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Country | US
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Telephone | 941-485-1505
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Fax | 941-492-4065
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOSEPH NOAH
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Credential | M.D.
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Telephone | 941-485-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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