Healthcare Provider Details

I. General information

NPI: 1952330771
Provider Name (Legal Business Name): GREGORY F SARIC M.D., P.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10549 N FLORIDA AVE STE A
TAMPA FL
33612-6707
US

IV. Provider business mailing address

PO BOX 17175
TAMPA FL
33682-7175
US

V. Phone/Fax

Practice location:
  • Phone: 813-220-1400
  • Fax: 813-252-3006
Mailing address:
  • Phone: 813-220-1400
  • Fax: 813-252-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberXS3211810
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME75719
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME75719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: