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General NPI Number Information
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NPI Number | 1962719161
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Entity Type | Organization
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Legal Business Name | DOCTOR VISIT, P.A.
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 20191 E COUNTRY CLUB DR APT 2111
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City | AVENTURA
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State | FL
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Zip | 33180-3012
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Country | US
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Telephone | 954-224-8737
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Fax | 305-937-4022
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Provider Business Mailing Address
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Address Line | 20191 E COUNTRY CLUB DR APT 2111
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City | AVENTURA
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State | FL
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Zip | 33180-3012
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Country | US
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Telephone | 954-224-8737
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Fax | 305-937-4022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY A SACK
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Credential | M.D.
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Telephone | 954-450-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME59745
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License Number State | FL
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