Individual
EVGENY IDRISOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239
(941) 917-4896
(941) 917-6884
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME131245
FL
207R00000X
Internal Medicine Physician
TRN21341
FL
207RG0100X
Gastroenterology Physician
ME131245
FL
207RG0100X
Gastroenterology Physician
Primary
PENDING
OK
Other
Enumeration date
04/24/2015
Last updated
07/05/2022
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