Provider Demographics
NPI:1841204112
Name:MICHAEL D SACCENTE DO PA
Entity Type:Organization
Organization Name:MICHAEL D SACCENTE DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SACCENTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-544-9326
Mailing Address - Street 1:1251 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3587
Mailing Address - Country:US
Mailing Address - Phone:727-544-9326
Mailing Address - Fax:727-544-9601
Practice Address - Street 1:1251 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3587
Practice Address - Country:US
Practice Address - Phone:727-544-9326
Practice Address - Fax:727-544-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty