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Individual

DISA G SACKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1282 US HIGHWAY 1, SUITE 4, ROCKLEDGE, FL 32955-2747
(321) 632-4800
(321) 632-6320
Mailing address
1282 US HIGHWAY 1, SUITE 4, ROCKLEDGE, FL 32955-2747
(321) 632-4800
(321) 632-6320

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
ME60948
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
370893400
FL
Enumeration date
08/31/2006
Last updated
03/16/2010
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