MEDICARE: SUNCOAST FAMILY MEDICINE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		FL

General Provider Information

NPI Number	:	1659760676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST FAMILY MEDICINE PA

Provider Business Mailing Address
First Line	:	7322 MANATEE AVE W # 108
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3441
Country	:	US
Telephone Number	:	941-747-8600
Fax Number	:	941-749-5915

Provider Business Practice Location Address
First Line	:	7322 MANATEE AVE W # 108
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3441
Country	:	US
Telephone Number	:	941-747-8600
Fax Number	:	941-749-5915

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIC M FOLKENS
Credential	:	MD
Telephone Number	:	941-747-8600

Provider Enumeration Date	:	01/14/2015
Last Update Date	:	01/09/2025

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