Jacaranda Family Medicine P a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JACARANDA FAMILY MEDICINE P A

Practice address

4315 Tamiami TRL S
Venice, FL 34293-5117

Phone

(941) 497-4303

Fax

(941) 497-3107

NPI assigned

Apr 19, 2006

Last updated

Sep 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen A. Sollott, D.O.

Title

Owner

Phone

(941) 497-4303

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1174588586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935117",
            "telephone_number": "941-497-4303",
            "fax_number": "941-497-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935117",
            "telephone_number": "941-497-4303",
            "fax_number": "941-497-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACARANDA FAMILY MEDICINE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "SOLLOTT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-497-4303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254050900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN3383",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• J & J Will-Care, Inc.
• Jacaranda Pointe Anesthesia PL
• Mark A Jackson, LCSW
• Peggy Jackson, ARNP-BC, NP-C
• Ellen Marie Jacob, LCSW, CDP
• Tara Elizabeth Jacobson, BS

• Family Medicine Physician in Venice, FL
• Providers in Venice, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.