| La Salud Medical Center Inc | |
|
2970 University Pkwy Ste 104 Sarasota FL 34243-2401 | |
| (941) 242-0934 | |
| (941) 242-0936 |
| Full Name | La Salud Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2970 University Pkwy Ste 104, Sarasota, Florida |
| Authorized Official Name and Position | Mercedes Ripoll (CEO) |
| Authorized Official Contact | 9412420934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Salud Medical Center Inc 2970 University Pkwy Ste 204 Sarasota FL 34243-2401 Ph: (941) 242-0934 | La Salud Medical Center Inc 2970 University Pkwy Ste 104 Sarasota FL 34243-2401 Ph: (941) 242-0934 |
| NPI Number | 1265888457 |
|---|---|
| Provider Enumeration Date | 05/06/2016 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 4284058942 |
|---|---|
| Medicare Enrollment ID | O20200728001865 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265888457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Diana Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124412564 PECOS PAC ID: 6406101880 Enrollment ID: I20180626003395 |
| Provider Name | Ike A Boka |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205944931 PECOS PAC ID: 4587846217 Enrollment ID: I20200529002027 |
| Provider Name | Dayami Rosales Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063948875 PECOS PAC ID: 4981024775 Enrollment ID: I20201016000372 |
| Provider Name | Gregory A Avetisov |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679917280 PECOS PAC ID: 9335470400 Enrollment ID: I20201027000040 |
| Provider Name | Miguel A Prado Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811595002 PECOS PAC ID: 6103238308 Enrollment ID: I20201211001609 |
| Provider Name | Carl David Bramson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689693368 PECOS PAC ID: 2264838762 Enrollment ID: I20210909000130 |
| Provider Name | Adrian A Isaza |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326537820 PECOS PAC ID: 8022408392 Enrollment ID: I20211130001336 |
| Provider Name | Fermin F Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982367769 PECOS PAC ID: 2961896386 Enrollment ID: I20220301002141 |
| Provider Name | Yamirka Dieguez-fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720732118 PECOS PAC ID: 6305233982 Enrollment ID: I20220428002730 |
| Provider Name | Katherine Rodriguez |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1194165951 PECOS PAC ID: 9032577671 Enrollment ID: I20230616000644 |
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