Provider Demographics
NPI:1235696139
Name:VERIMED HEALTH GROUP SARASOTA, LLC
Entity Type:Organization
Organization Name:VERIMED HEALTH GROUP SARASOTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:REVELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-991-4000
Mailing Address - Street 1:5741 BEE RIDGE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5083
Mailing Address - Country:US
Mailing Address - Phone:813-717-9000
Mailing Address - Fax:813-717-9005
Practice Address - Street 1:5741 BEE RIDGE RD STE 220
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5083
Practice Address - Country:US
Practice Address - Phone:813-717-9000
Practice Address - Fax:813-717-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty