| Shadrick Kralik Md Pa | |
|
2198 Main St Sarasota FL 34237-6024 | |
| (941) 315-9155 | |
| (727) 674-1317 |
| Full Name | Shadrick Kralik Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2198 Main St, Sarasota, Florida |
| Authorized Official Name and Position | Shadrick Kralik (PRESIDENT/OWNER) |
| Authorized Official Contact | 9413159155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadrick Kralik Md Pa 2198 Main St Sarasota FL 34237-6024 Ph: (941) 315-9155 | Shadrick Kralik Md Pa 2198 Main St Sarasota FL 34237-6024 Ph: (941) 315-9155 |
| NPI Number | 1912593203 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 06/13/2023 |
| Medicare PECOS PAC ID | 4789097742 |
|---|---|
| Medicare Enrollment ID | O20210112001000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912593203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Tara Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578916508 PECOS PAC ID: 0941583264 Enrollment ID: I20170213000815 |
| Provider Name | Jacqueline A Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184134611 PECOS PAC ID: 5496012080 Enrollment ID: I20171207000723 |
| Provider Name | Joseph F Lindley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538556675 PECOS PAC ID: 6204105745 Enrollment ID: I20180703001503 |
| Provider Name | Ketan J Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154810117 PECOS PAC ID: 2365794278 Enrollment ID: I20181003003359 |
| Provider Name | Leo Lin Kao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013385830 PECOS PAC ID: 7416292487 Enrollment ID: I20200124001030 |
| Provider Name | Nicole Benovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467993923 PECOS PAC ID: 8527325687 Enrollment ID: I20200930001466 |
| Provider Name | Shadrick Paul Kralik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588181358 PECOS PAC ID: 3870859572 Enrollment ID: I20210112001258 |
| Provider Name | Kimberley Sue Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972223212 PECOS PAC ID: 3274900691 Enrollment ID: I20221027001796 |
| Provider Name | Emily Lynn Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174208532 PECOS PAC ID: 1658732532 Enrollment ID: I20230726000600 |
| Provider Name | Daniel Damian Burroughs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679220263 PECOS PAC ID: 4385097633 Enrollment ID: I20240202000530 |
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