| Atlantic Cove Medical Group, Llc | |
|
1949 Northgate Blvd Sarasota FL 34234-2143 | |
| (941) 208-3070 | |
| (941) 208-3067 |
| Full Name | Atlantic Cove Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1949 Northgate Blvd, Sarasota, Florida |
| Authorized Official Name and Position | Collins Ezeuka (CEO) |
| Authorized Official Contact | 9412083070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic Cove Medical Group, Llc 5342 Clark Rd # 3072 Sarasota FL 34233-3227 Ph: () - | Atlantic Cove Medical Group, Llc 1949 Northgate Blvd Sarasota FL 34234-2143 Ph: (941) 208-3070 |
| NPI Number | 1851172019 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 11/16/2023 |
| Medicare PECOS PAC ID | 8022465525 |
|---|---|
| Medicare Enrollment ID | O20231106000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851172019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Collins Ezeuka |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730522590 PECOS PAC ID: 7214033695 Enrollment ID: I20220308003010 |
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