Healthcare Provider Details

I. General information

NPI: 1417903493
Provider Name (Legal Business Name): BONNIE R. SAKS, MD & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W KENNEDY BLVD SUITE 106
TAMPA FL
33609-2976
US

IV. Provider business mailing address

3333 W KENNEDY BLVD SUITE 106
TAMPA FL
33609-2976
US

V. Phone/Fax

Practice location:
  • Phone: 813-354-9444
  • Fax: 813-354-9436
Mailing address:
  • Phone: 813-354-9444
  • Fax: 813-354-9436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. BONNIE RAE SAKS
Title or Position: SOLE PROPRIETOR
Credential: MD
Phone: 813-354-9444