Provider Demographics
NPI:1316223688
Name:AIDA BAJRAMOVIC
Entity Type:Organization
Organization Name:AIDA BAJRAMOVIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJRAMOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:941-894-3490
Mailing Address - Street 1:1801 ARLINGTON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3502
Mailing Address - Country:US
Mailing Address - Phone:941-894-3490
Mailing Address - Fax:
Practice Address - Street 1:1801 ARLINGTON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3502
Practice Address - Country:US
Practice Address - Phone:941-894-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106276363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty