Provider Demographics
NPI:1952648974
Name:SACOWI MEDICAL CONSULTANTS INC
Entity Type:Organization
Organization Name:SACOWI MEDICAL CONSULTANTS INC
Other - Org Name:SACOWI MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-592-6073
Mailing Address - Street 1:365 WEKIVA SPRINGS RD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3684
Mailing Address - Country:US
Mailing Address - Phone:407-960-6075
Mailing Address - Fax:888-622-0903
Practice Address - Street 1:365 WEKIVA SPRINGS RD
Practice Address - Street 2:SUITE 231
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3684
Practice Address - Country:US
Practice Address - Phone:407-960-6075
Practice Address - Fax:888-622-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty