Provider Demographics
NPI:1922010966
Name:NENIC, SAVA D (MD)
Entity Type:Individual
Prefix:
First Name:SAVA
Middle Name:D
Last Name:NENIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 TURKEY LAKE RD
Mailing Address - Street 2:MP 452
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8001
Mailing Address - Country:US
Mailing Address - Phone:321-843-5500
Mailing Address - Fax:321-843-5177
Practice Address - Street 1:9400 TURKEY LAKE RD
Practice Address - Street 2:MP 452
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8001
Practice Address - Country:US
Practice Address - Phone:321-843-5500
Practice Address - Fax:321-843-5177
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA836690207RC0200X
OH35090669207RC0200X
FLME102214207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A836690Medicaid
FL000220400Medicaid
OH2789746Medicaid
P00474036Medicare PIN
FL000220400Medicaid
OH2789746Medicaid
OHNE4222651Medicare PIN