Provider Demographics
NPI:1013972421
Name:CARDIOVASCULAR CARE OF SARASOTA PA
Entity Type:Organization
Organization Name:CARDIOVASCULAR CARE OF SARASOTA PA
Other - Org Name:SARASOTA CARDIOVASCULAR GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PULEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-377-8266
Mailing Address - Street 1:5741 BEE RIDGE RD
Mailing Address - Street 2:SUITE 490
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5064
Mailing Address - Country:US
Mailing Address - Phone:941-377-8266
Mailing Address - Fax:941-378-9545
Practice Address - Street 1:5741 BEE RIDGE RD
Practice Address - Street 2:SUITE 490
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5064
Practice Address - Country:US
Practice Address - Phone:941-377-8266
Practice Address - Fax:941-378-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK3021OtherRR MEDICARE
FL264940302Medicaid
FL264940300Medicaid
FL34301OtherBCBS
FL264940300Medicaid
FL34301OtherBCBS