Organization
SAGO SUPERIOR MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAFIYA A GORDON ARNP (PRESIDENT)
(727) 320-7879
Entity
Organization
Contact information
Practice address
3040 36TH AVE S, ST PETERSBURG, FL 33712-3731
(727) 320-7879
(727) 865-3242
Mailing address
PO BOX 15485, ST PETERSBURG, FL 33733
(727) 320-7879
(727) 865-3242
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
9176677
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308592900
—
FL
Enumeration date
07/24/2008
Last updated
07/30/2008
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