| Take Aim Psychotherapy | |
|
741 S Beneva Rd Sarasota FL 34232-2411 | |
| (941) 387-4070 | |
| (941) 922-4742 |
| Full Name | Take Aim Psychotherapy |
|---|---|
| Speciality | Internal Medicine |
| Location | 741 S Beneva Rd, Sarasota, Florida |
| Authorized Official Name and Position | Wayne S Blake (OWNER) |
| Authorized Official Contact | 9413874070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Take Aim Psychotherapy Po Box 15342 Sarasota FL 34277-1342 Ph: (941) 387-4070 | Take Aim Psychotherapy 741 S Beneva Rd Sarasota FL 34232-2411 Ph: (941) 387-4070 |
| NPI Number | 1861921199 |
|---|---|
| Provider Enumeration Date | 06/09/2017 |
| Last Update Date | 06/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861921199 | NPI | - | NPPES |
| 280257100 | Medicaid | FL | |
| OS10255 | Other | FL | STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS10255 (Florida) | Primary |
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