Provider Demographics
NPI:1477785509
Name:OAKS FAMILY PRACTICE PA
Entity Type:Organization
Organization Name:OAKS FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-966-4949
Mailing Address - Street 1:8620 S TAMIAMI TRL
Mailing Address - Street 2:SUITE F-G
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-3049
Mailing Address - Country:US
Mailing Address - Phone:941-966-4949
Mailing Address - Fax:
Practice Address - Street 1:8620 S TAMIAMI TRL
Practice Address - Street 2:SUITE F-G
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-3049
Practice Address - Country:US
Practice Address - Phone:941-966-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1760477285Medicare NSC
FL1285691055Medicare NSC