Provider Demographics
NPI:1295857027
Name:WHOLE HEALTH MEDICAL LLC
Entity type:Organization
Organization Name:WHOLE HEALTH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:PATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-266-4754
Mailing Address - Street 1:5436 FRUITVILLE RD
Mailing Address - Street 2:#121
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6403
Mailing Address - Country:US
Mailing Address - Phone:941-954-0266
Mailing Address - Fax:941-954-0243
Practice Address - Street 1:8404 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2936
Practice Address - Country:US
Practice Address - Phone:941-966-4443
Practice Address - Fax:941-966-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70272207NS0135X, 208200000X, 2086S0122X
FLME059641207RH0002X, 208100000X, 208D00000X, 207R00000X
FLME86466207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty