Provider Demographics
NPI:1043209463
Name:FORD, ANIT DOLORES (MD)
Entity Type:Individual
Prefix:
First Name:ANIT
Middle Name:DOLORES
Last Name:FORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3920 BEE RIDGE RD STE H
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-926-8855
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:3920 BEE RIDGE RD STE H
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-926-8855
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0622719OtherAETNA
FL080182335OtherRAIL ROAD MEDICARE
FL18403OtherBCBS
FL080182335OtherRAIL ROAD MEDICARE
FL3422934OtherCIGNA
FL651151535001OtherMEDICAL MUTUAL
FL21145OtherAVMED
FL18403OtherBCBS
FL3422934OtherHEALTHPARTNERS
FL3422934OtherHEALTHPARTNERS
FL471179OtherAMERIHEALTH