1104847896 NPI number — SHEILA SAGAR M.D.

Table of content: SHEILA SAGAR M.D. (NPI 1104847896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104847896 NPI number — SHEILA SAGAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAGAR
Provider First Name:
SHEILA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAGAR
Provider Other First Name:
SHEELA
Provider Other Middle Name:
V
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1104847896
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28960 US HIGHWAY 19 N
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33761-2403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-787-7970
Provider Business Mailing Address Fax Number:
727-787-8524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28960 US HIGHWAY 19 N
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33761-2403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-787-7970
Provider Business Practice Location Address Fax Number:
727-787-8524
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME76182 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 255315500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00231527 . This is a "RAILROAD MEDICARE PROVIDE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 116460500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com