Healthcare Provider Details

I. General information

NPI: 1245722974
Provider Name (Legal Business Name): ALEX SABO DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N BAYSHORE DR APT 4508
MIAMI FL
33132-3025
US

IV. Provider business mailing address

1900 N BAYSHORE DR APT 4508
MIAMI FL
33132-3025
US

V. Phone/Fax

Practice location:
  • Phone: 954-579-3916
  • Fax: 954-239-3902
Mailing address:
  • Phone: 954-579-3916
  • Fax: 954-239-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberOS13097
License Number StateFL

VIII. Authorized Official

Name: ALEX SABO
Title or Position: OWNER
Credential: DO
Phone: 954-416-1781