Provider Demographics
NPI:1871760199
Name:BONNIE R SAKS MD AND ASSOCIATES LLC
Entity type:Organization
Organization Name:BONNIE R SAKS MD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-354-9444
Mailing Address - Street 1:3333 W KENNEDY BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2976
Mailing Address - Country:US
Mailing Address - Phone:813-354-9444
Mailing Address - Fax:813-354-9436
Practice Address - Street 1:3333 W KENNEDY BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2976
Practice Address - Country:US
Practice Address - Phone:813-354-9444
Practice Address - Fax:813-354-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP318832261QA0600X
FLME0039891261QM0850X
FLARNP2603542261QM0850X
FLMH0002956261QM0850X
FLSW768261QM0850X
FLSW782261QM0850X
FLSW9045261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care