Provider Demographics
NPI:1487800025
Name:MANASOTA MEDICAL GROUP LLC
Entity type:Organization
Organization Name:MANASOTA MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRICE, MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-365-7771
Mailing Address - Street 1:1250 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2221
Mailing Address - Country:US
Mailing Address - Phone:941-365-7771
Mailing Address - Fax:941-365-4071
Practice Address - Street 1:1250 S TAMIAMI TRL
Practice Address - Street 2:SUITE 301
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2221
Practice Address - Country:US
Practice Address - Phone:941-365-7771
Practice Address - Fax:941-365-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty