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3004 Seasons Boulivard Sarasota FL 34240 | |
| (941) 894-7429 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 3004 Seasons Boulivard, Sarasota, Florida |
| Authorized Official Name and Position | Jeffrey S Lyons (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9418947429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3004 Seasons Blvd Sarasota FL 34240-8230 Ph: () - | 3004 Seasons Boulivard Sarasota FL 34240 Ph: (941) 894-7429 |
| NPI Number | 1982984134 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 08/19/2011 |
| Medicare PECOS PAC ID | 7911171491 |
|---|---|
| Medicare Enrollment ID | O20111118000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982984134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS7077 (Florida) | Primary |
| Provider Name | Jeffrey Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851386908 PECOS PAC ID: 7911924501 Enrollment ID: I20110209000198 |
| Provider Name | Shelly Lynn Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740360122 PECOS PAC ID: 4486750734 Enrollment ID: I20181129003139 |
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