Individual
SASWATA ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11705 SAN JOSE BLVD, STE 103, JACKSONVILLE, FL 32223-1835
(904) 880-0911
(904) 880-9388
Mailing address
11945 SAN JOSE BLVD, STE 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 396-4893
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
ME92036
FL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
ME92036
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271475200
—
FL
Enumeration date
08/22/2006
Last updated
11/30/2016
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