Healthcare Provider Details

I. General information

NPI: 1649618760
Provider Name (Legal Business Name): GARY E SAVILL, PH.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 MOVA ST
SARASOTA FL
34231-7718
US

IV. Provider business mailing address

1828 MOVA ST
SARASOTA FL
34231-7718
US

V. Phone/Fax

Practice location:
  • Phone: 941-586-6880
  • Fax: 941-894-1105
Mailing address:
  • Phone: 941-586-6880
  • Fax: 941-894-1105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberPY 7528
License Number StateFL

VIII. Authorized Official

Name: DR. GARY E SAVILL
Title or Position: LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 941-586-6880