Basic Information
| Provider Information | |||||||||
| NPI: | 1245306422 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANIT D FORD MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3920 BEE RIDGE RD | ||||||||
| Address2: | BLDG E STE H | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342331207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419268855 | ||||||||
| FaxNumber: | 9419268145 | ||||||||
| Practice Location | |||||||||
| Address1: | 3920 BEE RIDGE RD | ||||||||
| Address2: | BLDG E STE H | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342331207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419268855 | ||||||||
| FaxNumber: | 9419268145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 03/21/2014 | ||||||||
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| AuthorizedOfficialLastName: | FORD | ||||||||
| AuthorizedOfficialFirstName: | ANIT | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9419268855 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | DH 0631 | 01 | FL | RR MEDICARE | OTHER |