Provider Demographics
NPI:1811034770
Name:MEDICAL PROVIDERS INC.
Entity Type:Organization
Organization Name:MEDICAL PROVIDERS INC.
Other - Org Name:SARASOTA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:941-927-1234
Mailing Address - Street 1:4450 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3454
Mailing Address - Country:US
Mailing Address - Phone:941-927-1234
Mailing Address - Fax:941-921-0043
Practice Address - Street 1:4450 SOUTH TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3454
Practice Address - Country:US
Practice Address - Phone:941-927-1234
Practice Address - Fax:941-921-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1805261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL511926OtherCARE CHOICES
FL511926OtherPREFFERED CHOICES
FL324172OtherCOVENTRY
FL324172OtherHEALTH AMERICA
FL324172OtherADVANTRA
FL615420OtherHARVARD PILGRIM HPHC
FL8208458OtherAETNA
FL98400OtherBCBS
FL5500285OtherGHI
FLCJ0514OtherRAIL ROAD MEDICARE
FL8208458OtherAETNA