Healthcare Provider Details

I. General information

NPI: 1710958970
Provider Name (Legal Business Name): JOHN T SAEVA D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10221 US HIGHWAY 98 W STE 19
DESTIN FL
32550-4967
US

IV. Provider business mailing address

10221 US HIGHWAY 98 W STE 19
DESTIN FL
32550-4967
US

V. Phone/Fax

Practice location:
  • Phone: 850-650-6492
  • Fax: 850-650-2178
Mailing address:
  • Phone: 850-650-6492
  • Fax: 850-650-2178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO2452
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: