Provider Demographics
NPI:1558326777
Name:GULFCOAST ORTHOPAEDIC CENTER, PA
Entity Type:Organization
Organization Name:GULFCOAST ORTHOPAEDIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-921-2600
Mailing Address - Street 1:PO BOX 919031
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9031
Mailing Address - Country:US
Mailing Address - Phone:941-921-2600
Mailing Address - Fax:941-925-8672
Practice Address - Street 1:2800 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5103
Practice Address - Country:US
Practice Address - Phone:941-921-2600
Practice Address - Fax:941-925-8672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID