Provider Demographics
NPI:1407323561
Name:SDS MEDICAL, LLC
Entity type:Organization
Organization Name:SDS MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FANE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:941-378-5100
Mailing Address - Street 1:5831 BEE RIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5090
Mailing Address - Country:US
Mailing Address - Phone:941-378-5100
Mailing Address - Fax:941-960-1962
Practice Address - Street 1:5831 BEE RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5090
Practice Address - Country:US
Practice Address - Phone:941-284-8471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty