| Reliable Md Llc | |
|
5045 Fruitville Rd Unit 123b Sarasota FL 34232-2268 | |
| (727) 203-4613 | |
| Not Available |
| Full Name | Reliable Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5045 Fruitville Rd Unit 123b, Sarasota, Florida |
| Authorized Official Name and Position | Rob Durante (PRESIDENT) |
| Authorized Official Contact | 7812529900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reliable Md Llc 35 United Drive West Bridgewater MA 02379-1027 Ph: (508) 238-8646 | Reliable Md Llc 5045 Fruitville Rd Unit 123b Sarasota FL 34232-2268 Ph: (727) 203-4613 |
| NPI Number | 1700400280 |
|---|---|
| Provider Enumeration Date | 06/01/2020 |
| Last Update Date | 11/29/2021 |
| Medicare PECOS PAC ID | 3072936533 |
|---|---|
| Medicare Enrollment ID | O20200701000973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700400280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QS1201X | Family Medicine - Sleep Medicine | (* (Not Available)) | Secondary |
| Provider Name | Carlos Gustavo Levy |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780789891 PECOS PAC ID: 9537066352 Enrollment ID: I20031218000291 |
| Provider Name | Victor E De Loach |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982693123 PECOS PAC ID: 9133178825 Enrollment ID: I20050120000206 |
| Provider Name | Kelly E Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265981682 PECOS PAC ID: 0941589451 Enrollment ID: I20230227002978 |
| Provider Name | Johanna Jovanovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891400693 PECOS PAC ID: 1951774009 Enrollment ID: I20230310001358 |
| Provider Name | Amber Ishmael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205350915 PECOS PAC ID: 8123394624 Enrollment ID: I20231017003291 |
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