Provider Demographics
NPI:1659540235
Name:PETER L SARKOS MD PL
Entity Type:Organization
Organization Name:PETER L SARKOS MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SARKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-384-4972
Mailing Address - Street 1:7855 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1134
Mailing Address - Country:US
Mailing Address - Phone:727-384-4972
Mailing Address - Fax:727-341-2708
Practice Address - Street 1:7855 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1134
Practice Address - Country:US
Practice Address - Phone:727-384-4972
Practice Address - Fax:727-341-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93650174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28693OtherBCBS
FL8673211OtherCIGNA
FL273419200Medicaid
FL273419200Medicaid
FL28693OtherBCBS
FL8673211OtherCIGNA