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DISA GAGE SACKS MD PA NPI 1649594847


NPI Information

NPI: 1649594847
Provider Name: DISA GAGE SACKS MD PA
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1282 S US HIGHWAY 1
SUITE 4
ROCKLEDGE, FL
ZIP 32955
Phone: (321) 632-4800
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DISA GAGE SACKS MD PA is a specialist in Rockledge, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DISA GAGE SACKS MD PA NPI is 1649594847. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1282 S US HIGHWAY 1
SUITE 4
ROCKLEDGE, FL
ZIP 32955-747
Phone: (321) 632-4800
Fax: (321) 632-6320

The provider's authorized official is Deborah L Nicoletti .
The authorized official title is Office Manager and has the following contact phone number (321) 632-4800.

The enumeration date for this NPI number is 3/17/2010 and was last updated on 4/6/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistME0060948FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
117805MEDICARE UPINFLORIDA
2370893400MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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