Provider Demographics
NPI:1407874357
Name:SAI, THEOPHILUS TORGBOR (MD)
Entity Type:Individual
Prefix:
First Name:THEOPHILUS
Middle Name:TORGBOR
Last Name:SAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 W HORATIO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3028
Mailing Address - Country:US
Mailing Address - Phone:813-600-9981
Mailing Address - Fax:
Practice Address - Street 1:3105 N 22ND ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-1915
Practice Address - Country:US
Practice Address - Phone:813-626-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-109016207R00000X
FLME101036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY744XMedicare PIN