MEDICARE: DR. BASHAR S SAIKALY 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
1	207RC0000X	Cardiovascular Disease Physician	ME 78252	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060055960	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	46619	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700880390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASHAR S SAIKALY MD

Provider Business Mailing Address
First Line	:	3550 UNIVERSITY BLVD S
Second Line	:	STE 302
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4225
Country	:	US
Telephone Number	:	904-733-4444
Fax Number	:	904-733-5377

Provider Business Practice Location Address
First Line	:	300 HEALTH PARK BLVD
Second Line	:	SUITE 1006
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-3707
Country	:	US
Telephone Number	:	904-794-7050
Fax Number	:	904-794-7135

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/09/2012

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