| Living Well Clinic Llc | |
|
7333 Scotland Way Sarasota FL 34238-8530 | |
| (941) 552-5355 | |
| Not Available |
| Full Name | Living Well Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7333 Scotland Way, Sarasota, Florida |
| Authorized Official Name and Position | James W Cater (CEO) |
| Authorized Official Contact | 9415525355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Well Clinic Llc 7333 Scotland Way Sarasota FL 34238-8530 Ph: (941) 552-5355 | Living Well Clinic Llc 7333 Scotland Way Sarasota FL 34238-8530 Ph: (941) 552-5355 |
| NPI Number | 1942847256 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 12/05/2019 |
| Medicare PECOS PAC ID | 5799108767 |
|---|---|
| Medicare Enrollment ID | O20200709000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942847256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Joann Irving |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821041716 PECOS PAC ID: 8022028067 Enrollment ID: I20060504000423 |
| Provider Name | Ira B Azneer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750389045 PECOS PAC ID: 4486756038 Enrollment ID: I20070228000214 |
| Provider Name | Deniese Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679991624 PECOS PAC ID: 2668624867 Enrollment ID: I20141125001149 |
| Provider Name | Douglas J Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689079337 PECOS PAC ID: 9739405507 Enrollment ID: I20150316000057 |
| Provider Name | Philip William Fioret |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710933650 PECOS PAC ID: 4789769738 Enrollment ID: I20161220002332 |
| Provider Name | Kathryn H Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821241910 PECOS PAC ID: 4789741877 Enrollment ID: I20190404001571 |
| Provider Name | Amy Kathleen Lhote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013940691 PECOS PAC ID: 5193918167 Enrollment ID: I20190716002938 |
| Provider Name | Dynie Stanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487246401 PECOS PAC ID: 2062812084 Enrollment ID: I20210614001679 |
| Provider Name | Emily Hope Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255826707 PECOS PAC ID: 1355699836 Enrollment ID: I20211109000403 |
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