Provider Demographics
NPI:1326127929
Name:PHYSIO MED OF SARASOTA INC
Entity type:Organization
Organization Name:PHYSIO MED OF SARASOTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SUTPHIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-925-8273
Mailing Address - Street 1:5766 BRONX AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231
Mailing Address - Country:US
Mailing Address - Phone:941-925-8273
Mailing Address - Fax:941-925-9027
Practice Address - Street 1:5766 BRONX AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-925-8273
Practice Address - Fax:941-925-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty