Provider Demographics
NPI:1043255029
Name:NEPHROLOGY ASSOCIATES OF SARASOTA
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF SARASOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:RANJAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GHOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-917-6585
Mailing Address - Street 1:1921 WALDEMERE ST
Mailing Address - Street 2:SUITE 413
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2941
Mailing Address - Country:US
Mailing Address - Phone:941-917-6585
Mailing Address - Fax:941-917-6514
Practice Address - Street 1:1921 WALDEMERE ST
Practice Address - Street 2:SUITE 413
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2943
Practice Address - Country:US
Practice Address - Phone:941-917-6585
Practice Address - Fax:941-917-6514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC11284OtherRAILROAD MEDICARE
FL99236OtherBLUE CROSS BLUE SHEILD OF FL
FL62887500Medicaid
FL62887500Medicaid