Provider Demographics
NPI:1447257522
Name:LEGASPI SAUTER, ADRIAN (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:LEGASPI SAUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-823-8510
Mailing Address - Fax:305-823-8530
Practice Address - Street 1:7150 W 20TH AVE STE 615
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5511
Practice Address - Country:US
Practice Address - Phone:305-820-6657
Practice Address - Fax:305-820-6658
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00520942086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6089OtherDIMENSION HLTH. PROV. #
FL6237616-003OtherCIGNA PROVIDER NUMBER
FL04603OtherBCBS PROVIDER NUMBER
FL732140OtherFIRST HEALTH PROVIDER #
FL000697900Medicaid
FL4260320OtherAETNA PROVIDER NUMBER
FLP00197OtherDOC. CARE THRU PMG PROV #
FL104347OtherAVMED PROVIDER NUMBER
FL5157424OtherCCN PROVIDER NUMBER
FL22404OtherWELLCARE PROVIDER NUMBER
FL00275OtherPREF. CARE. PRTN. PROV. #
FL104347OtherAVMED PROVIDER NUMBER
FL000697900Medicaid