Provider Demographics
NPI:1780989483
Name:SARASOTA MEDICAL CARE PA
Entity type:Organization
Organization Name:SARASOTA MEDICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WELLINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-552-8808
Mailing Address - Street 1:PO BOX 3558
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-3558
Mailing Address - Country:US
Mailing Address - Phone:941-552-8808
Mailing Address - Fax:941-552-8805
Practice Address - Street 1:3530 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-9026
Practice Address - Country:US
Practice Address - Phone:941-552-8808
Practice Address - Fax:941-552-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30555208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty