Organization Active NPI

Fifty Third Ave East Medical Clinic

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1619139151
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0049009 Issued in FL
Legal business name
FIFTY THIRD AVE EAST MEDICAL CLINIC
Practice address
3900 Clark Rd
Suite B3 & B4
Sarasota, FL 34233-2301
Phone
(941) 755-2456
Fax
(941) 932-4795
NPI assigned
Jun 26, 2008
Organization subpart
Yes
Parent organization
FIFTY THIRD AVE EAST MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Dr. Padmini Rajan
Title
President
Phone
(941) 755-2456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0049009 FL Primary

Addresses

Primary practice location

3900 Clark Rd
Suite B3 & B4
Sarasota, FL 34233-2301

Mailing address

712 53Rd Ave E
Suite C
Bradenton, FL 34203-5827
Phone (941) 755-2456

National Provider Directory

National Provider Directory
Part of
53Rd Ave East Medical Center PA

Locations

3900 Clark Rd
Ste B3
Sarasota, FL 34233
Phone (941) 379-0088

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1619139151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 53RD AVE E",
            "address_2": "SUITE C",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342035827",
            "telephone_number": "941-755-2456",
            "fax_number": "941-932-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CLARK RD",
            "address_2": "SUITE B3 & B4",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332301",
            "telephone_number": "941-755-2456",
            "fax_number": "941-932-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTY THIRD AVE EAST MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIFTY THIRD AVE EAST MEDICAL CLINIC",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "RAJAN",
        "authorized_official_first_name": "PADMINI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-755-2456",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0049009",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 26, 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.