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General NPI Number Information
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NPI Number | 1700808698
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Entity Type | Organization
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Legal Business Name | ALFONSO H SAA MD PA NEW CORP
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 4620 N. HABANA AVE. SUITE 202
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City | TAMPA
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State | FL
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Zip | 33614-7107
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Country | US
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Telephone | 813-875-8550
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Fax | 813-875-8402
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Provider Business Mailing Address
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Address Line | 4620 N. HABANA AVE. SUITE 202
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City | TAMPA
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State | FL
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Zip | 33614-7107
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Country | US
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Telephone | 813-875-8550
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Fax | 813-875-8402
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALFONSO H. SAA
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Credential | M.D.
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Telephone | 813-875-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME34182
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License Number State | FL
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