MEDICARE: KATHLEEN SAZAMA M.D. JD

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	207ZB0001X	Blood Banking & Transfusion Medicine Physician	ME103651	FL

General Provider Information

NPI Number	:	1396840914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN SAZAMA M.D. JD

Provider Business Mailing Address
First Line	:	4039 W NEWBERRY RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-2342
Country	:	US
Telephone Number	:	352-224-1640
Fax Number	:	352-224-1650

Provider Business Practice Location Address
First Line	:	4039 W NEWBERRY RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-2342
Country	:	US
Telephone Number	:	352-224-1640
Fax Number	:	352-224-1650

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	04/08/2009

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