Healthcare Provider Details

I. General information

NPI: 1063848661
Provider Name (Legal Business Name): PATTI LYNN SAGES DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28400 OLD 41 RD
BONITA SPRINGS FL
34135-6812
US

IV. Provider business mailing address

1100 PINE RIDGE RD STE B304
NAPLES FL
34108-8923
US

V. Phone/Fax

Practice location:
  • Phone: 239-992-8387
  • Fax: 239-949-0232
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number174M00000X
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: