Provider Demographics
NPI:1467687434
Name:SACK, JAYSON A (MD)
Entity Type:Individual
Prefix:
First Name:JAYSON
Middle Name:A
Last Name:SACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2590 HEALING WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5497
Mailing Address - Country:US
Mailing Address - Phone:813-782-5801
Mailing Address - Fax:813-782-5732
Practice Address - Street 1:2590 HEALING WAY STE 210
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5497
Practice Address - Country:US
Practice Address - Phone:813-782-5801
Practice Address - Fax:813-782-5732
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME128209207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery