MEDICARE: SAGE SCALES PHARMD

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	183500000X	Pharmacist	PS69440	FL

General Provider Information

NPI Number	:	1164301347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAGE SCALES PHARMD

Provider Business Mailing Address
First Line	:	6121 SE LANDING WAY APT 8
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-1891
Country	:	US
Telephone Number	:	850-490-0161
Fax Number	:

Provider Business Practice Location Address
First Line	:	9801 S US HIGHWAY 1
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5628
Country	:	US
Telephone Number	:	772-337-2553
Fax Number	:

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

Provider Enumeration Date	:	09/01/2025
Last Update Date	:	09/01/2025

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Directions to “ SAGE SCALES PHARMD” Practice Location

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