Provider Demographics
NPI:1073526018
Name:JUAN SAUER, MD, PA
Entity Type:Organization
Organization Name:JUAN SAUER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-841-1971
Mailing Address - Street 1:1802 BELLEVUE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2933
Mailing Address - Country:US
Mailing Address - Phone:407-841-1971
Mailing Address - Fax:407-841-1403
Practice Address - Street 1:1802 BELLEVUE AVE STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2933
Practice Address - Country:US
Practice Address - Phone:407-841-1971
Practice Address - Fax:407-841-1403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 28259174400000X
FLME0028259282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037088600Medicaid
FL037088600Medicaid
K1118Medicare PIN