Provider Demographics
NPI:1053502278
Name:SHAUN F SAINT MD PA
Entity Type:Organization
Organization Name:SHAUN F SAINT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAINT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-563-9912
Mailing Address - Street 1:4489 N CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-6019
Mailing Address - Country:US
Mailing Address - Phone:352-563-9912
Mailing Address - Fax:352-795-2642
Practice Address - Street 1:4489 N CITRUS AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-6019
Practice Address - Country:US
Practice Address - Phone:352-563-9912
Practice Address - Fax:352-795-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98461208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279024600Medicaid