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NPI Code Detail

MEDICARE: DEBABRATA SAHA MD

MEDICARE: DEBABRATA SAHA 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
12084P0800XPsychiatry PhysicianME62418FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225190523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBABRATA SAHA MD
Provider Business Mailing Address
First Line : PO BOX 19249
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32245-9249
Country : US
Telephone Number : 904-743-1883
Fax Number : 904-743-5109
Provider Business Practice Location Address
First Line : 11820 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-6670
Country : US
Telephone Number : 904-642-9100
Fax Number : 904-642-9108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 02/21/2014

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1922161785 — MRS. ALISON BOEHNKE BS
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1063575827 — RASHEEDAH STOWE
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1215078803 — MS. AMY MARIE NELSON LMHC
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Directions to “ DEBABRATA SAHA MD” Practice Location

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