Provider Demographics
NPI:1528472149
Name:ERIC PATRUSKY DO PA
Entity type:Organization
Organization Name:ERIC PATRUSKY DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-377-8687
Mailing Address - Street 1:3920 BEE RIDGE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-377-8687
Mailing Address - Fax:941-378-3498
Practice Address - Street 1:3920 BEE RIDGE RD STE C
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-377-8687
Practice Address - Fax:941-378-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS6274OtherMEDICAL LICENSE