Provider Demographics
NPI:1023422391
Name:VERIMED HEALTH GROUP BRADENTON LLC
Entity type:Organization
Organization Name:VERIMED HEALTH GROUP BRADENTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENNEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALOGERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-833-7226
Mailing Address - Street 1:300 RIVERSIDE DR.
Mailing Address - Street 2:SUITE 3900
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208
Mailing Address - Country:US
Mailing Address - Phone:813-415-5038
Mailing Address - Fax:
Practice Address - Street 1:300 RIVERSIDE DR E
Practice Address - Street 2:SUITE 3900
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1008
Practice Address - Country:US
Practice Address - Phone:813-415-5038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care