Provider Demographics
NPI:1801050141
Name:OB GYN SPECIALISTS OF SARASOTA PLLC
Entity type:Organization
Organization Name:OB GYN SPECIALISTS OF SARASOTA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-379-5343
Mailing Address - Street 1:8451 SHADE AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2878
Mailing Address - Country:US
Mailing Address - Phone:941-360-0960
Mailing Address - Fax:786-975-2643
Practice Address - Street 1:8451 SHADE AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2878
Practice Address - Country:US
Practice Address - Phone:941-360-0960
Practice Address - Fax:786-975-2643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94509207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty