Provider Demographics
NPI:1104847896
Name:SAGAR, SHEILA (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:SAGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEELA
Other - Middle Name:V
Other - Last Name:SAGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:28960 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2403
Mailing Address - Country:US
Mailing Address - Phone:727-787-7970
Mailing Address - Fax:727-787-8524
Practice Address - Street 1:28960 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2403
Practice Address - Country:US
Practice Address - Phone:727-787-7970
Practice Address - Fax:727-787-8524
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255315500Medicaid
FLP00231527OtherRAILROAD MEDICARE PROVIDE
FL44544AMedicare ID - Type UnspecifiedMEDICARE PROVIDER#
FL255315500Medicaid