Organization
FIFTY THIRD AVE EAST MEDICAL CLINIC
Active
Parent organization
FIFTY THIRD AVE EAST MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIFTY THIRD AVE EAST MEDICAL CLINIC
Authorized official
DR. PADMINI RAJAN (PRESIDENT)
(941) 755-2456
Entity
Organization
Contact information
Practice address
3900 CLARK RD, SUITE B3 & B4, SARASOTA, FL 34233-2301
(941) 755-2456
(941) 932-4795
Mailing address
712 53RD AVE E, SUITE C, BRADENTON, FL 34203-5827
(941) 755-2456
(941) 932-4795
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0049009
FL
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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