Provider Demographics
NPI:1831194026
Name:SARASOTA CARDIOVASCULAR & THORACIC SURGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:SARASOTA CARDIOVASCULAR & THORACIC SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-952-1947
Mailing Address - Street 1:1540 S TAMIAMI TRL
Mailing Address - Street 2:STE 301
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2921
Mailing Address - Country:US
Mailing Address - Phone:941-952-1913
Mailing Address - Fax:941-952-1969
Practice Address - Street 1:1540 S TAMIAMI TRL
Practice Address - Street 2:STE 301
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2921
Practice Address - Country:US
Practice Address - Phone:941-952-1913
Practice Address - Fax:941-952-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL586400296208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA2018OtherRAILROAD MEDICARE GROUP #
FL34714OtherBCBS GROUP PROVIDER #
FL267235900Medicaid
FLK4358Medicare ID - Type UnspecifiedMEDICARE PROVIDER #