NPIMap

Organization Active NPI

Gulf Coast Pediatrics of Sarasota, PA-C

  • Specialist
  • Venice, FL
National Provider Identifier
1255489308
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME56640 Issued in FL
Legal business name
GULF COAST PEDIATRICS OF SARASOTA, PA-C
Practice address
405 Commercial CT Ste D
Venice, FL 34292-1653
Phone
(941) 412-1515
Fax
(941) 412-1525
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Dr. Richard Allen Perez, M.D.NPI 1477559516
Title
President
Phone
(941) 412-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME56640 FL Primary

Addresses

Primary practice location

405 Commercial CT Ste D
Venice, FL 34292-1653

Mailing address

5664 Bee Ridge Rd
Ste. 202
Sarasota, FL 34233-1504
Phone (941) 377-6406

Other identifiers 1

IdentifierTypeStateIssuer
268427601MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Pediatrics of Sarasota2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1255489308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5664 BEE RIDGE RD",
            "address_2": "STE. 202",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331504",
            "telephone_number": "941-377-6406",
            "fax_number": "941-377-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 COMMERCIAL CT STE D",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921653",
            "telephone_number": "941-412-1515",
            "fax_number": "941-412-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PEDIATRICS OF SARASOTA, PA-C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-412-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME56640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268427601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.