| Md-prp Llc | |
|
4020 Sawyer Rd Sarasota FL 34233-1272 | |
| (717) 350-4254 | |
| Not Available |
| Full Name | Md-prp Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4020 Sawyer Rd, Sarasota, Florida |
| Authorized Official Name and Position | Mena Ayoub (OWNER) |
| Authorized Official Contact | 7173504254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md-prp Llc 4020 Sawyer Rd Sarasota FL 34233-1272 Ph: (717) 350-4254 | Md-prp Llc 4020 Sawyer Rd Sarasota FL 34233-1272 Ph: (717) 350-4254 |
| NPI Number | 1548048374 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 06/11/2024 |
| Medicare PECOS PAC ID | 4183070915 |
|---|---|
| Medicare Enrollment ID | O20231030002797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548048374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mena S Ayoub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285167692 PECOS PAC ID: 0042583957 Enrollment ID: I20200918000968 |
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