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Organization
JACARANDA FAMILY MEDICINE P A
Active
Organization
JACARANDA FAMILY MEDICINE P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A. SOLLOTT D.O. (OWNER)
(941) 497-4303
Entity
Organization
Contact information
Practice address
4315 TAMIAMI TRL S, VENICE, FL 34293-5117
(941) 497-4303
(941) 497-3107
Mailing address
4315 TAMIAMI TRL S, VENICE, FL 34293-5117
(941) 497-4303
(941) 497-3107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254050900
—
FL
01
—
DN3383
RAILROAD MEDICARE
FL
Enumeration date
04/19/2006
Last updated
09/29/2008
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