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1693 Main St Suite A Sarasota FL 34236-5864 | |
| (941) 255-2374 | |
| (941) 366-0033 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1693 Main St, Sarasota, Florida |
| Authorized Official Name and Position | Christine Anne Cauffield (OWNER) |
| Authorized Official Contact | 9419939921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1693 Main St Suite A Sarasota FL 34236-5864 Ph: (941) 255-2374 | 1693 Main St Suite A Sarasota FL 34236-5864 Ph: (941) 255-2374 |
| NPI Number | 1780917336 |
|---|---|
| Provider Enumeration Date | 09/15/2009 |
| Last Update Date | 09/06/2011 |
| Medicare PECOS PAC ID | 3870628761 |
|---|---|
| Medicare Enrollment ID | O20101021000459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780917336 | NPI | - | NPPES |
| 251B00000X | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 6095 (Florida) | Primary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| Provider Name | Heather M Brathwaite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083628028 PECOS PAC ID: 0648178012 Enrollment ID: I20031222000915 |
| Provider Name | Jean M Oconnor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659473148 PECOS PAC ID: 1951449602 Enrollment ID: I20091117000593 |
| Provider Name | Christine A Cauffield |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316152309 PECOS PAC ID: 8820167349 Enrollment ID: I20101129000761 |
| Provider Name | Lyntressa Danielle Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083955793 PECOS PAC ID: 3375784911 Enrollment ID: I20130724000965 |
| Provider Name | Jeffrey M Hoffman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558421800 PECOS PAC ID: 7618903162 Enrollment ID: I20160622001283 |
| Provider Name | Deborah Kimbler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649514563 PECOS PAC ID: 4082902424 Enrollment ID: I20161018000731 |
| Provider Name | Lauren M Woodruff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053539098 PECOS PAC ID: 1951689868 Enrollment ID: I20161027001961 |
| Provider Name | Ana Maria Borrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013289651 PECOS PAC ID: 0345529798 Enrollment ID: I20161108001306 |
| Provider Name | Eduardo Manuel La Rosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417471152 PECOS PAC ID: 9133495534 Enrollment ID: I20171031001365 |
| Provider Name | Margot Beth Hampson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649429648 PECOS PAC ID: 7315113412 Enrollment ID: I20210422001803 |
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