# SARASOTA MEDICAL CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760415574
- **Authorized official:** MS. AVERY R. DYE (BILLING)
- **Authorized official phone:** (941) 921-5741

## Contact information

- **Practice address:** 5640 MARQUESAS CIR, SARASOTA, FL 34233-3331
- **Practice address phone:** (941) 921-5741
- **Practice address fax:** (941) 927-5746
- **Mailing address:** 5640 MARQUESAS CIR, SARASOTA, FL 34233-3331
- **Mailing address phone:** (941) 921-5741
- **Mailing address fax:** (941) 927-5746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | NULL | Yes |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | — | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 11/08/2010