NPIMap

Organization Active NPI

Imminent Surgical Associates PA

  • Surgery Physician
  • Sarasota, FL
National Provider Identifier
1316338551
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME113621 Issued in FL
Legal business name
IMMINENT SURGICAL ASSOCIATES PA
Practice address
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone
(941) 404-6211
Fax
(877) 274-4518
NPI assigned
Feb 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Ali Ziad Al-Rawi
Title
Owner
Phone
(941) 404-6211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X ME113621 FL Primary

Addresses

Primary practice location

1700 S Tamiami TRL
Sarasota, FL 34239-3509

Mailing address

PO Box 15365
Sarasota, FL 34277-1365
Phone (941) 404-6211

Other identifiers 1

IdentifierTypeStateIssuer
014458600MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1316338551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15365",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342771365",
            "telephone_number": "941-404-6211",
            "fax_number": "877-274-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393509",
            "telephone_number": "941-404-6211",
            "fax_number": "877-274-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMINENT SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "AL-RAWI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "ZIAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-404-6211"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME113621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014458600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.