MD-PRP LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MD-PRP LLC

Practice address

4020 Sawyer Rd
Sarasota, FL 34233-1272

Phone

(717) 350-4254

NPI assigned

Sep 21, 2023

Organization subpart

No

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

Authorized official

Name

Mena AyoubNPI 1285167692

Title

Owner

Phone

(717) 350-4254

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Mena Ayoub

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1285167692
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1548048374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SAWYER RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331272",
            "telephone_number": "717-350-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 SAWYER RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331272",
            "telephone_number": "717-350-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD-PRP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "MENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-350-4254"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.