Provider Demographics
NPI:1417903493
Name:BONNIE R. SAKS, MD & ASSOCIATES
Entity Type:Organization
Organization Name:BONNIE R. SAKS, MD & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SAKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-354-9444
Mailing Address - Street 1:3333 W KENNEDY BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2976
Mailing Address - Country:US
Mailing Address - Phone:813-354-9444
Mailing Address - Fax:813-354-9436
Practice Address - Street 1:3333 W KENNEDY BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2976
Practice Address - Country:US
Practice Address - Phone:813-354-9444
Practice Address - Fax:813-354-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7067Medicare ID - Type UnspecifiedGROUP ID NUMBER