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General NPI Number Information
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NPI Number | 1316923147
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Entity Type | Individual
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Provider Name | JEFFREY BRETT SACK MD FACC FACA FCCP
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 5471 BEE RIDGE RD SUITE 260
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City | SARASOTA
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State | FL
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Zip | 34233
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Country | US
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Telephone | 941-371-3800
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Fax | 941-371-2069
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Provider Business Mailing Address
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Address Line | PO BOX 15157
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City | SARASOTA
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State | FL
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Zip | 34277-1157
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Country | US
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Telephone | 941-371-3800
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Fax | 941-371-2069
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME0056807
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License Number State | FL
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