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General NPI Number Information
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NPI Number | 1912142050
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Entity Type | Organization
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Legal Business Name | MICHAEL J SAKELLARIDES MD PA
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 5341 GRAND BLVD # 104
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4011
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Country | US
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Telephone | 727-848-7818
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Fax | 727-848-0050
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Provider Business Mailing Address
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Address Line | 5341 GRAND BLVD # 104
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4011
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Country | US
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Telephone | 727-848-7818
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Fax | 727-848-0050
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Authorized Official
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Title or Position | DOCTOR
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Name | MICHAEL J SAKELLARIDES
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Credential | M.D.
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Telephone | 727-848-7818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME18453
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License Number State | FL
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