Provider Demographics
NPI:1598495301
Name:SAVAGE, SORAYA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:SORAYA
Middle Name:ANN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15303 AMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2308
Mailing Address - Country:US
Mailing Address - Phone:813-751-9127
Mailing Address - Fax:813-441-7373
Practice Address - Street 1:15303 AMBERLY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2308
Practice Address - Country:US
Practice Address - Phone:813-751-9127
Practice Address - Fax:813-441-7373
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019241163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11019241OtherMEDICAL LICENSE