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General NPI Number Information
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NPI Number | 1962429449
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Entity Type | Individual
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Provider Name | STANLEY S SACK MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 1201 WHITE ST SUITE 103
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City | KEY WEST
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State | FL
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Zip | 33040-3328
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Country | US
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Telephone | 305-295-0598
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Fax | 305-295-0597
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Provider Business Mailing Address
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Address Line | 1201 WHITE ST SUITE 103
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City | KEY WEST
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State | FL
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Zip | 33040-3328
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Country | US
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Telephone | 305-292-0598
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Fax | 305-295-0597
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 59258
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License Number State | MA
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