Healthcare Provider Details

I. General information

NPI: 1255999405
Provider Name (Legal Business Name): SAISYSTEMS HEALTH FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 VISTA PKWY STE 400
WEST PALM BEACH FL
33411-6742
US

IV. Provider business mailing address

5 RESEARCH DR
SHELTON CT
06484-6232
US

V. Phone/Fax

Practice location:
  • Phone: 203-929-0790
  • Fax:
Mailing address:
  • Phone: 203-929-0790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MANOJ WADHWANI
Title or Position: VICE PRESIDENT
Credential:
Phone: 203-567-5211