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NPI Code Detail

MEDICARE: RICHARD M SAG MD PA

MEDICARE: RICHARD M SAG MD PA
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
1208000000XPediatrics PhysicianME46257FL

General Provider Information

NPI Number : 1306022884
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD M SAG MD PA
Provider Business Mailing Address
First Line : PO BOX 741240
Second Line :
City : ORANGE CITY
State : FL
Zip : 32774-1240
Country : US
Telephone Number : 376-774-5211
Fax Number : 386-774-5251
Provider Business Practice Location Address
First Line : 5401 ALHAMBRA DR
Second Line : SUITE D
City : ORLANDO
State : FL
Zip : 32808-7081
Country : US
Telephone Number : 407-297-1497
Fax Number : 407-297-8917
Authorized Official
Title or Position : AGENT/REPRESENTATIVE
Name : MR. ROBERT COOLIDGE
Credential :
Telephone Number : 376-774-5211
Provider Enumeration Date : 01/15/2008
Last Update Date : 01/15/2008

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