MEDICARE: JOANNE LYNN SAG ARPN

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	ARNP1894492	FL

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

General Provider Information

NPI Number	:	1073696266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE LYNN SAG ARPN

Provider Business Mailing Address
First Line	:	PO BOX 741240
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32774-1240
Country	:	US
Telephone Number	:	386-774-5211
Fax Number	:	386-774-5251

Provider Business Practice Location Address
First Line	:	5401 ALHAMBRA AVENUE
Second Line	:	SUITE D RICHARD M SAG MD PA
City	:	ORLANDO
State	:	FL
Zip	:	32808-7081
Country	:	US
Telephone Number	:	407-297-1497
Fax Number	:	407-297-8917

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	05/16/2008

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