| Sarasota Spine & Joint Integrated Medical | |
|
3900 Clark Rd H-1 Sarasota FL 34233-2301 | |
| (941) 926-1600 | |
| (941) 926-1166 |
| Full Name | Sarasota Spine & Joint Integrated Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 3900 Clark Rd, Sarasota, Florida |
| Authorized Official Name and Position | Jonathan Alan Berman (OWNER) |
| Authorized Official Contact | 9419261600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarasota Spine & Joint Integrated Medical 3900 Clark Rd H-1 Sarasota FL 34233-2301 Ph: (941) 926-1600 | Sarasota Spine & Joint Integrated Medical 3900 Clark Rd H-1 Sarasota FL 34233-2301 Ph: (941) 926-1600 |
| NPI Number | 1174861165 |
|---|---|
| Provider Enumeration Date | 01/25/2013 |
| Last Update Date | 04/09/2018 |
| Medicare PECOS PAC ID | 8426293127 |
|---|---|
| Medicare Enrollment ID | O20130401000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174861165 | NPI | - | NPPES |
| 7276950001 | Other | FL | DME |
| DU2456 | Other | FL | RR MEDICARE |
| HA944A | Other | FL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Ali R Salari |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144438573 PECOS PAC ID: 9133285547 Enrollment ID: I20130904000146 |
| Provider Name | Ali R Salari |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144438573 PECOS PAC ID: 9133285547 Enrollment ID: I20130926000651 |
| Provider Name | Justin R Harris |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205179306 PECOS PAC ID: 0244550176 Enrollment ID: I20180813001185 |
| Provider Name | Sandra T. F Van Gennip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619466406 PECOS PAC ID: 1759630478 Enrollment ID: I20180814001209 |
| Provider Name | Samuel T Uzabel |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1427019918 PECOS PAC ID: 7618904103 Enrollment ID: I20221107002355 |
| Provider Name | Steve Odeh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801940200 PECOS PAC ID: 8820078553 Enrollment ID: I20221111000026 |
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