Provider Demographics
NPI:1962487975
Name:SAITH, ANGELI D (MD)
Entity Type:Individual
Prefix:
First Name:ANGELI
Middle Name:D
Last Name:SAITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 SOUTHLAKE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32571-7006
Mailing Address - Country:US
Mailing Address - Phone:850-384-7584
Mailing Address - Fax:
Practice Address - Street 1:14 W JORDAN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1736
Practice Address - Country:US
Practice Address - Phone:850-472-0045
Practice Address - Fax:850-436-2095
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81844207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB908OtherHEALTH FIRST NETWORK
FL265368100Medicaid
AL591-74315OtherBLUE CROSS BLUE SHIELD
FL29072OtherBLUE CROSS BLUE SHIELD
FL265368100Medicaid
FLB908OtherHEALTH FIRST NETWORK