Provider Demographics
NPI:1568472983
Name:KING, SYDNEY WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:WILLIAM
Last Name:KING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5139
Mailing Address - Country:US
Mailing Address - Phone:941-917-8185
Mailing Address - Fax:941-917-8085
Practice Address - Street 1:3100 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5139
Practice Address - Country:US
Practice Address - Phone:941-917-8185
Practice Address - Fax:941-917-8085
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54605207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07879OtherBCBS
FL037301000Medicaid
FLA89107Medicare UPIN
FL037301000Medicaid