Organization
STANLEY SACK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY SINCLAIR SACK MD (PRESIDENT)
(305) 292-0598
Entity
Organization
Contact information
Practice address
1201 WHITE ST, SUITE 103, KEY WEST, FL 33040-3328
(305) 295-7337
(305) 295-0597
Mailing address
1201 WHITE ST, SUITE 103, KEY WEST, FL 33040-3328
(305) 295-7337
(305) 295-0597
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 86306
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276711200
—
FL
01
—
58498
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
05/06/2008
Last updated
10/29/2008
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