Provider Demographics
NPI:1164000600
Name:SAACKE, AUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:SAACKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 BELGIAN DR APT 8305
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3433
Mailing Address - Country:US
Mailing Address - Phone:904-403-8819
Mailing Address - Fax:
Practice Address - Street 1:1000 N WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8937
Practice Address - Country:US
Practice Address - Phone:321-242-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL58654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist