Provider Demographics
NPI:1497022529
Name:ADVANCED EAR CARE MEDICAL CORP
Entity Type:Organization
Organization Name:ADVANCED EAR CARE MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:941-920-3759
Mailing Address - Street 1:4640 SANIBEL WAY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3149
Mailing Address - Country:US
Mailing Address - Phone:941-920-3759
Mailing Address - Fax:
Practice Address - Street 1:4232 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-3516
Practice Address - Country:US
Practice Address - Phone:941-920-3759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility