Provider Demographics
NPI:1558394114
Name:JACINTO, SERGIO J (MD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:J
Last Name:JACINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4507 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-7770
Mailing Address - Country:US
Mailing Address - Phone:813-876-4100
Mailing Address - Fax:813-876-4153
Practice Address - Street 1:4507 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4742
Practice Address - Country:US
Practice Address - Phone:813-876-4100
Practice Address - Fax:813-876-4153
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME66271174400000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No174400000XOther Service ProvidersSpecialist