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General NPI Number Information
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NPI Number | 1790142560
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Entity Type | Organization
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Legal Business Name | SAFA MEDICAL, INC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 728 BLANDING BLVD SUITE C
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City | ORANGE PARK
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State | FL
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Zip | 32065-7728
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Country | US
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Telephone | 904-503-9650
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Fax | 904-503-9627
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Provider Business Mailing Address
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Address Line | PO BOX 65069
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City | ORANGE PARK
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State | FL
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Zip | 32065-0002
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Country | US
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Telephone | 904-503-9650
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Fax | 904-503-9627
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Authorized Official
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Title or Position | PRESIDENT
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Name | SABA SAJID
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Credential | MD
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Telephone | 904-221-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME114281
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License Number State | FL
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