Provider Demographics
NPI:1013976422
Name:SARASOTA ORTHOPEDIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:SARASOTA ORTHOPEDIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SEWALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-552-3309
Mailing Address - Street 1:2750 BAHIA VISTA STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2640
Mailing Address - Country:US
Mailing Address - Phone:941-951-2663
Mailing Address - Fax:941-957-4437
Practice Address - Street 1:2750 BAHIA VISTA STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2640
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:941-957-4437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061701600Medicaid
FL77749Medicare ID - Type Unspecified