MEDICARE: DR. NICHOLO J. SARTOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME113841	FL
2	207R00000X	Internal Medicine Physician	9801478	NC
3	208000000X	Pediatrics Physician	9801478	NC
4	207R00000X	Internal Medicine Physician	ME113841	FL
5	208M00000X	Hospitalist Physician	ME113841	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	370016486	OTHER	NC	RAILROAD MEDICARE
3	GP476X	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	ME113841	OTHER	FL	LICENSE
5	1167P	OTHER	NC	BCBS OF NC
6	82667	OTHER	NC	MEDCOST INSURANCE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013992759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLO J. SARTOR MD

Provider Business Mailing Address
First Line	:	1801 LEE RD STE 165
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2127
Country	:	US
Telephone Number	:	407-975-0410
Fax Number	:	407-975-0413

Provider Business Practice Location Address
First Line	:	1801 LEE RD STE 165
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789
Country	:	US
Telephone Number	:	407-975-0410
Fax Number	:	407-975-0413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	07/26/2019

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