MEDICARE: SACOWI MEDICAL CONSULTANTS INC

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	207R00000X	Internal Medicine Physician	ME98157	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1952648974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACOWI MEDICAL CONSULTANTS INC

Provider Business Mailing Address
First Line	:	365 WEKIVA SPRINGS RD
Second Line	:	SUITE 231
City	:	LONGWOOD
State	:	FL
Zip	:	32779-3684
Country	:	US
Telephone Number	:	407-960-6075
Fax Number	:	888-622-0903

Provider Business Practice Location Address
First Line	:	365 WEKIVA SPRINGS RD
Second Line	:	SUITE 231
City	:	LONGWOOD
State	:	FL
Zip	:	32779-3684
Country	:	US
Telephone Number	:	407-960-6075
Fax Number	:	888-622-0903

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. SAMUEL JEAN
Credential	:	M.D.
Telephone Number	:	407-592-6073

Provider Enumeration Date	:	01/10/2013
Last Update Date	:	02/06/2013

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