Healthcare Provider Details

I. General information

NPI: 1003668682
Provider Name (Legal Business Name): SAIJ SAYLES LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 LEE RD STE 122B
WINTER PARK FL
32789-2104
US

IV. Provider business mailing address

33446 E LAKE JOANNA DR
EUSTIS FL
32736-7234
US

V. Phone/Fax

Practice location:
  • Phone: 407-502-9111
  • Fax:
Mailing address:
  • Phone: 689-777-0539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4519
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: