Healthcare Provider Details

I. General information

NPI: 1528266426
Provider Name (Legal Business Name): MICHAEL TROY SAILERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: M. TROY SAILERS M.D.

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10141 BIG BEND RD SUITE 101
RIVERVIEW FL
33578-7419
US

IV. Provider business mailing address

10141 BIG BEND RD STE 101
RIVERVIEW FL
33578-7419
US

V. Phone/Fax

Practice location:
  • Phone: 813-397-1270
  • Fax: 813-397-1271
Mailing address:
  • Phone: 813-397-1270
  • Fax: 813-397-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301091750
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME126172
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: