Provider Demographics
NPI:1326074634
Name:MEDICALT CORPORATION
Entity Type:Organization
Organization Name:MEDICALT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:TREITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-957-4500
Mailing Address - Street 1:1931 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3115
Mailing Address - Country:US
Mailing Address - Phone:941-957-4500
Mailing Address - Fax:941-957-4501
Practice Address - Street 1:1931 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3115
Practice Address - Country:US
Practice Address - Phone:941-957-4500
Practice Address - Fax:941-957-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8786Medicare ID - Type Unspecified