Provider Demographics
NPI:1659072999
Name:PREMIER PHYSICIANS OF SARASOTA LLC
Entity Type:Organization
Organization Name:PREMIER PHYSICIANS OF SARASOTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-951-3920
Mailing Address - Street 1:1843 FLOYD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2937
Mailing Address - Country:US
Mailing Address - Phone:941-951-3920
Mailing Address - Fax:941-951-3922
Practice Address - Street 1:1843 FLOYD ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2937
Practice Address - Country:US
Practice Address - Phone:941-951-3920
Practice Address - Fax:941-951-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1598774390OtherNPI
37767OtherFLORIDA BLUE PAYOR ID
37854OtherFLORIDA BLUE PAYOR ID
1427161066OtherNPI
1790717908OtherNPI
1174685499OtherNPI
14885OtherFLORIDA BLUE PAYOR ID
37912OtherFLORIDA BLUE PAYOR ID
1209159OtherAVAILITY CUSTOMER SENDER ID
87767OtherOLIVE