Basic Information
| Provider Information | |||||||||
| NPI: | 1780989483 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SARASOTA MEDICAL CARE PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3558 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342303558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415528808 | ||||||||
| FaxNumber: | 9415528805 | ||||||||
| Practice Location | |||||||||
| Address1: | 3530 FRUITVILLE RD | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342379026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415528808 | ||||||||
| FaxNumber: | 9415528805 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2011 | ||||||||
| LastUpdateDate: | 01/11/2011 | ||||||||
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| AuthorizedOfficialLastName: | CHEN | ||||||||
| AuthorizedOfficialFirstName: | WELLINGTON | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9415528808 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME30555 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.