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NPI Code Detail

MEDICARE: CHRISTI LEIGH SAKLAD-COSTELLO PA

MEDICARE: CHRISTI LEIGH SAKLAD-COSTELLO 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 PhysicianMA051738PA
2363AM0700XMedical Physician AssistantMA051738PA
3363A00000XPhysician AssistantPA9109647FL

General Provider Information

NPI Number : 1316933880
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTI LEIGH SAKLAD-COSTELLO PA
Provider Business Mailing Address
First Line : 151 SOUTHHALL LN STE 300
Second Line :
City : MAITLAND
State : FL
Zip : 32751-7172
Country : US
Telephone Number : 866-400-3376
Fax Number : 407-650-3455
Provider Business Practice Location Address
First Line : 8 OFFICE PARK DR
Second Line :
City : PALM COAST
State : FL
Zip : 32137-3808
Country : US
Telephone Number : 866-400-3376
Fax Number : 863-446-6066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 01/22/2024

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Directions to “ CHRISTI LEIGH SAKLAD-COSTELLO PA” Practice Location

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