Healthcare Provider Details

I. General information

NPI: 1740790633
Provider Name (Legal Business Name): SHEILA SAGAR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28960 US HIGHWAY 19 N STE 100
CLEARWATER FL
33761-2403
US

IV. Provider business mailing address

28960 US HIGHWAY 19 N STE 100
CLEARWATER FL
33761-2403
US

V. Phone/Fax

Practice location:
  • Phone: 727-787-7970
  • Fax: 727-787-8524
Mailing address:
  • Phone: 727-787-7970
  • Fax: 727-787-8524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9302708
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME76182
License Number StateFL

VIII. Authorized Official

Name: KARIN ARMERO
Title or Position: ADMINISTRATOR
Credential:
Phone: 727-459-3235