Provider Demographics
NPI:1265665681
Name:SUGAR ORTHOPAEDICS PA
Entity Type:Organization
Organization Name:SUGAR ORTHOPAEDICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-329-1308
Mailing Address - Street 1:1630 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3108
Mailing Address - Country:US
Mailing Address - Phone:941-556-6900
Mailing Address - Fax:941-556-6920
Practice Address - Street 1:1630 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3108
Practice Address - Country:US
Practice Address - Phone:941-556-6900
Practice Address - Fax:941-556-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001414700Medicaid
DQ0681OtherRR MEDICARE
DQ0681OtherRR MEDICARE
6360770001Medicare NSC
FLCR237AMedicare PIN