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General NPI Number Information
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NPI Number | 1508228743
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Entity Type | Individual
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Provider Name | JANA SACCO MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2016
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 655 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-3940
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Fax |
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Provider Business Mailing Address
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Address Line | 6082 MOUNTAINGATE DR
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City | NIAGARA FALLS
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State | ONTARIO
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Zip | L2J4H8
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Country | US
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Telephone | 716-901-5355
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 156451
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License Number State | FL
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