Healthcare Provider Details

I. General information

NPI: 1740285006
Provider Name (Legal Business Name): ROBERT BLAKE SAYRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 W JORDAN ST STE C STE 1
PENSACOLA FL
32501-1737
US

IV. Provider business mailing address

14 W JORDAN ST STE C STE 1
PENSACOLA FL
32501-1737
US

V. Phone/Fax

Practice location:
  • Phone: 850-434-0077
  • Fax: 850-546-6122
Mailing address:
  • Phone: 850-434-0077
  • Fax: 850-546-6122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME80025
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: