| Entity Name: | THOMAS M. SWEENEY, II, M.D., PH.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Dec 2002 (22 years ago) |
| Document Number: | P02000135383 |
| FEI/EIN Number | 061670765 |
| Address: | 4117 Bee Ridge Rd, SARASOTA, FL, 34233, US |
| Mail Address: | 4117 Bee Ridge Rd, SARASOTA, FL, 34233, US |
| ZIP code: | 34233 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700891637 | 2006-07-29 | 2011-07-16 | 5922 CATTLEMEN LN STE 201, SARASOTA, FL, 342326204, US | 5922 CATTLEMEN LN STE 201, SARASOTA, FL, 342326204, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 941-371-9773 |
| Fax | 9415560341 |
Authorized person
| Name | DR. THOMAS MEDRICK SWEENEY II |
| Role | PRESIDENT |
| Phone | 9413719773 |
Taxonomy
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE SHIELD ID NUMBER |
| Number | 45493 |
| State | FL |
| Issuer | RAIL ROAD MEDICARE |
| Number | DB1611 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SWEENEY II THOMAS M | Agent | 4117 Bee Ridge Rd, SARASOTA, FL, 34233 |
| Name | Role | Address |
|---|---|---|
| SWEENEY II THOMAS M | President | 4117 Bee Ridge Rd, Sarasota, FL, 34233 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
