Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME 18453 | FL |
NPI | 1033170808 |
---|---|
Provider Name | Mr. Michael J Sakellarides |
First Address | New Port Richey, FL 34652 |
Second Address | New Port Richey, FL 34652-4011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 04/01/2011 |