Provider Demographics
NPI:1952330771
Name:SARIC, GREGORY F (MD, PC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:F
Last Name:SARIC
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17175
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-7175
Mailing Address - Country:US
Mailing Address - Phone:813-220-1400
Mailing Address - Fax:813-252-3006
Practice Address - Street 1:10549 N FLORIDA AVE STE I
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6707
Practice Address - Country:US
Practice Address - Phone:813-220-1400
Practice Address - Fax:813-252-3006
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLXS3211810207QA0401X
FLME75719207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2817359OtherCIGNA
FL103699500Medicaid
FL44848OtherBCBS
FL593580230OtherCHAMPUS
FL2817359OtherCIGNA
FL258112400Medicaid