| Mk New Life | |
|
3800 S Tamiami Trl Paradise Plaza Suite 305 Sarasota FL 34239-6908 | |
| (941) 275-7966 | |
| (941) 429-7705 |
| Full Name | Mk New Life |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3800 S Tamiami Trl, Sarasota, Florida |
| Authorized Official Name and Position | Masami Tanaka Kolbenschlag (PRESIDENT) |
| Authorized Official Contact | 9412757966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mk New Life 3800 S Tamiami Trl Paradise Plaza Suite 305 Sarasota FL 34239-6908 Ph: (941) 275-7966 | Mk New Life 3800 S Tamiami Trl Paradise Plaza Suite 305 Sarasota FL 34239-6908 Ph: (941) 275-7966 |
| NPI Number | 1447519913 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 05/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447519913 | NPI | - | NPPES |
| Z148M | Other | FL | BCBSFL |
| 60054 | Other | FL | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH9277 (Florida) | Primary |
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