Healthcare Provider Details
I. General information
NPI: 1073526018
Provider Name (Legal Business Name): JUAN SAUER, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1802 BELLEVUE AVE STE 102
ORLANDO FL
32806-2933
US
IV. Provider business mailing address
1802 BELLEVUE AVE STE 102
ORLANDO FL
32806-2933
US
V. Phone/Fax
- Phone: 407-841-1971
- Fax: 407-841-1403
- Phone: 407-841-1971
- Fax: 407-841-1403
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | ME 28259 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | ME0028259 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
JUAN
SAUER
Title or Position: PRESIDENT
Credential: MD
Phone: 407-841-1971