Provider Demographics
NPI:1013278662
Name:SARASOTA MANATEE GERIATRICS LLC
Entity Type:Organization
Organization Name:SARASOTA MANATEE GERIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-919-1593
Mailing Address - Street 1:8466 LOCKWOOD RIDGE RD
Mailing Address - Street 2:NUM 160
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2951
Mailing Address - Country:US
Mailing Address - Phone:941-228-0270
Mailing Address - Fax:941-460-5448
Practice Address - Street 1:5120 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-4705
Practice Address - Country:US
Practice Address - Phone:206-919-1593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3186252363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty