Healthcare Provider Details
I. General information
NPI: 1619973146
Provider Name (Legal Business Name): DONALD R SAVAGE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/21/2005
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5900 S JOHN YOUNG PKWY
ORLANDO FL
32839-3716
US
IV. Provider business mailing address
5900 S JOHN YOUNG PKWY
ORLANDO FL
32839-3716
US
V. Phone/Fax
- Phone: 407-398-6470
- Fax: 407-894-6872
- Phone: 407-398-6470
- Fax: 407-894-6872
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35-04-8034-S |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME 101452 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: