| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3924 9th Ave, Bradenton, Florida |
| Authorized Official Name and Position | Eric Folkens (PRESIDENT) |
| Authorized Official Contact | 9415240444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7322 Manatee Ave W # 108 Bradenton FL 34209-3441 Ph: (941) 447-5854 | 3924 9th Ave Bradenton FL 34205 Ph: (941) 447-5854 |
| NPI Number | 1215150396 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 01/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215150396 | NPI | - | NPPES |
| 1215150396 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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