Provider Demographics
NPI:1225846017
Name:MANATEE PRIMARY CARE LLC
Entity type:Organization
Organization Name:MANATEE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIADNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:URQUIZA MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-356-3218
Mailing Address - Street 1:7839 34TH CT E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2867
Mailing Address - Country:US
Mailing Address - Phone:941-356-3218
Mailing Address - Fax:
Practice Address - Street 1:6302 MANATEE AVE W STE D
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2355
Practice Address - Country:US
Practice Address - Phone:941-356-3218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty