PRESTIGE MEDICAL GROUP LLC (NPI# 1528440781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528440781 |
| Entity Type | Organization |
| Organization Name | PRESTIGE MEDICAL GROUP LLC |
| Practice Address |
6924 Professional Pkwy E Suite B Lakewood Ranch FL 34240-8414 |
| Mailing Address |
6924 Professional Pkwy E Ste B Lakewood Ranch FL 34240-8439 |
| Practice Telephone | 9417526002 |
| Practice Fax Number | 9417526008 |
| Mailing Telephone | 9413624000 |
| Mailing Fax Number | 9413624400 |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2017-09-28 |
| Authorized Official Name | MR. TIMOTHY JAY (OWNER) |
| Authorized Official Telephone | 9413624000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
6924 PROFESSIONAL PKWY E SUITE B |
| City | LAKEWOOD RANCH |
| State | FL |
| Zip Code | 34240-8414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548879794 | Vascular Specialist of Venice and Sarasota Pl | Radiology | 6600 University Parkway, #102, Sarasota, FL 34240 | 2020-07-23 |
| 1659918704 | Jessie Lee Mcgath | Behavior Technician | 8425 Vicela Drive, Sarasota, FL 34240 | 2019-12-09 |
| 1841847217 | Susan Lorraine Sell | Occupational Therapy Assistant | Sensory Solutions LLC, 22 Sarasota Center Blvd, Sarasota, FL 34240 | 2019-08-21 |
| 1366912990 | Mary Cecelia Prado | Behavior Technician | 6976 Professional Parkway, Lakewood Ranch, FL 34240 | 2018-11-27 |
| 1841783172 | Rachel M Sproha | Behavior Technician | 8259 Vicela Dr, Sarasota, FL 34240 | 2018-06-12 |
| 1942792767 | Performance Acupuncture | Acupuncturist | 5212 Paylor Ln, Sarasota, FL 34240 | 2018-06-06 |
| 1194125773 | Magnolia Dialysis LLC | Clinic/Center | 6960 Professional Pkwy E, Units 4 & 5, Sarasota, FL 34240 | 2014-09-02 |
| 1497164370 | Terrie Rierson | Speech-Language Pathologist | 63 Sarasota Center Blvd #101, Sarasota, FL 34240 | 2014-08-05 |
| 1982984134 | Angelheart LLC | Family Medicine | 3004 Seasons Boulivard, Sarasota, FL 34240 | 2011-08-19 |
| 1225259492 | Michael S Goren | Pharmacist | 775 Bell Road, Sarasota, FL 34240 | 2007-05-02 |
| Find all providers in zip 34240 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
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| 1184821860 | Dr. Salvatore Didomenico Dcpa | Clinic/Center | 7466 Edenmore Street, Lakewood Ranch, FL 34202 | 2007-06-27 |
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| Find all providers with the same taxonomy | ||||
| City | LAKEWOOD RANCH |
| Zip Code | 34240 |
Please comment or provide details below to improve the information on PRESTIGE MEDICAL GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.