Provider Demographics
NPI:1477819704
Name:SAXON MEDICAL GROUP, P.A.
Entity Type:Organization
Organization Name:SAXON MEDICAL GROUP, P.A.
Other - Org Name:TABREZ GASTROENTEROLOGY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAMS
Authorized Official - Middle Name:
Authorized Official - Last Name:TABREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-704-0668
Mailing Address - Street 1:11120 LAKE BUTLER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:818 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6625
Practice Address - Country:US
Practice Address - Phone:407-704-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty