| University Family Healthcare Pa | |
|
2401 University Pkwy Ste 100 Sarasota FL 34243-2894 | |
| (941) 351-2020 | |
| (941) 360-1362 |
| Full Name | University Family Healthcare Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 2401 University Pkwy Ste 100, Sarasota, Florida |
| Authorized Official Name and Position | Loren S Carlson (PRESIDENT) |
| Authorized Official Contact | 9413512020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Family Healthcare Pa 2401 University Pkwy Ste 100 Sarasota FL 34243-2894 Ph: (941) 351-2020 | University Family Healthcare Pa 2401 University Pkwy Ste 100 Sarasota FL 34243-2894 Ph: (941) 351-2020 |
| NPI Number | 1144402876 |
|---|---|
| Provider Enumeration Date | 12/05/2007 |
| Last Update Date | 12/05/2007 |
| Medicare PECOS PAC ID | 6901820018 |
|---|---|
| Medicare Enrollment ID | O20060117000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144402876 | NPI | - | NPPES |
| 258501400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2398 (Florida) | Primary |
| Provider Name | Brian D Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740420439 PECOS PAC ID: 9638364243 Enrollment ID: I20101109000803 |
| Provider Name | Loren Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902829419 PECOS PAC ID: 9638193741 Enrollment ID: I20111222000240 |
| Provider Name | Karen S Campbell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1265873178 PECOS PAC ID: 2365665809 Enrollment ID: I20140602000499 |
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