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5049 Ringwood Mdw Suite A Sarasota FL 34235-2035 | |
| (941) 342-7390 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 5049 Ringwood Mdw, Sarasota, Florida |
| Authorized Official Name and Position | William Rodriguez (OWNER) |
| Authorized Official Contact | 9085815574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 52284 Sarasota FL 34232-0319 Ph: (941) 342-7390 | 5049 Ringwood Mdw Suite A Sarasota FL 34235-2035 Ph: (941) 342-7390 |
| NPI Number | 1659744035 |
|---|---|
| Provider Enumeration Date | 11/05/2015 |
| Last Update Date | 11/10/2015 |
| Medicare PECOS PAC ID | 9830494178 |
|---|---|
| Medicare Enrollment ID | O20160224000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659744035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW12841 (Florida) | Primary |
| Provider Name | William J Roderick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598034415 PECOS PAC ID: 2860659422 Enrollment ID: I20160224000630 |
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