# FIFTY THIRD AVE EAST MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FIFTY THIRD AVE EAST MEDICAL CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619139151
- **Legal business name:** FIFTY THIRD AVE EAST MEDICAL CLINIC
- **Authorized official:** DR. PADMINI RAJAN (PRESIDENT)
- **Authorized official phone:** (941) 755-2456

## Contact information

- **Practice address:** 3900 CLARK RD, SUITE B3 & B4, SARASOTA, FL 34233-2301
- **Practice address phone:** (941) 755-2456
- **Practice address fax:** (941) 932-4795
- **Mailing address:** 712 53RD AVE E, SUITE C, BRADENTON, FL 34203-5827
- **Mailing address phone:** (941) 755-2456
- **Mailing address fax:** (941) 932-4795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME0049009 | FL | Yes |

## Other

- **Enumeration date:** 06/26/2008
- **Last updated:** 06/26/2008