SAGO SUPERIOR MANAGEMENT INC (NPI# 1811152366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811152366 |
Entity Type | Organization |
Organization Name | SAGO SUPERIOR MANAGEMENT INC |
Practice Address |
3040 36th Ave S St Petersburg FL 33712-3731 |
Mailing Address |
Po Box 15485 St Petersburg FL 33733 |
Practice Telephone | 7273207879 |
Practice Fax Number | 7278653242 |
Mailing Telephone | 7273207879 |
Mailing Fax Number | 7278653242 |
Enumeration Date | 2008-07-24 |
Last Update Date | 2008-07-30 |
Authorized Official Name | MS. SAFIYA A GORDON (PRESIDENT) |
Authorized Official Telephone | 7273207879 |
Authorized Official Credential | ARNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
9176677 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 308592900 | 05 |
Street Address |
3040 36TH AVE S |
City | ST PETERSBURG |
State | FL |
Zip Code | 33712-3731 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831663616 | Courtney Nicole West | Community Health Worker | 2335 22nd Ave S # 4, Saint Petersburg, FL 33712 | 2019-01-15 |
1053820266 | Tameka Flowers | Nurse Practitioner | 1719 Dayton Street South, Saint Petersburg, FL 33712 | 2017-09-20 |
1871030445 | Telesa Andrea Reddick | Specialist | 1407 22nd Street South, St Pete, FL 33712 | 2017-01-20 |
1104286715 | Touched By Faith Inc | Community/Behavioral Health | 2600 4th St, Saint Petersburg, FL 33712 | 2016-02-25 |
1457758476 | Chris Wendling | Pharmacist | 2620 Desoto Way S, St Petersburg, FL 33712 | 2014-11-20 |
1700217239 | Crystal Eva | Adult Companion | 2132 68th Ter S, St Petersburg, FL 33712 | 2013-12-10 |
1144598152 | Tien Minh Tran | Pharmacist | 3350 Central Avenue, St Petersburg, FL 33712 | 2011-12-05 |
1588947410 | Aru Richardson | Counselor | 555 31st Street South, Saint Petersburg, FL 33712 | 2011-09-27 |
1588990063 | Garrett A Babbs | Physician Assistant | 1344 22nd St South, St Petersburg, FL 33712 | 2009-10-19 |
1225216260 | Charlie Waller Colquitt | Pharmacist | 1344 22nd St So, St Petersburg, FL 33712 | 2008-02-01 |
Find all providers in zip 33712 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720644677 | Marie Helen Dailey | Nurse Practitioner | 10601 Gandy Blvd N Apt 2220, St Petersburg, FL 33702-1484 | 2019-05-16 |
1366919557 | Svetlana Nagle | Nurse Practitioner | 10601 Gandy Blvd. N., 5305, St Petersburg, FL 33702 | 2018-10-25 |
1801285051 | Ronsha Brown | Nurse Practitioner | 3551 42nd Ave S Ste B107, St Petersburg, FL 33711-4369 | 2015-01-12 |
1053718395 | Laurel Elizabeth Dimaggio | Nurse Practitioner | 3040 2nd Ave N, St Petersburg, FL 33713-8615 | 2014-12-02 |
1558790949 | Kristine Marie Sferra | Nurse Practitioner | 6325 23rd Ln N, St Petersburg, FL 33702-5624 | 2013-11-05 |
1770927485 | Charlotte Deolaso | Nurse Practitioner | 859 37th Ave Ne, St Petersburg, FL 33704-1621 | 2013-04-24 |
1023274727 | Kimberly Snyder Ristau | Nurse Practitioner | 5767 49th St N Ste A, St Petersburg, FL 33709-2106 | 2008-08-01 |
1841498623 | Sandra Marie Racine | Nurse Practitioner | 6499 38th Ave N Ste G1, St Petersburg, FL 33710-1658 | 2007-07-03 |
1013968189 | Brenda Dunlap | Nurse Practitioner | 900 49th St N, St Petersburg, FL 33710-6625 | 2006-05-13 |
1477510352 | Catherine Marie Prawer | Nurse Practitioner | 5101 Brittany Dr S, St Petersburg, FL 33715-1565 | 2006-04-26 |
Find all providers in ST PETERSBURG |
City | ST PETERSBURG |
Zip Code | 33712 |
Please comment or provide details below to improve the information on SAGO SUPERIOR MANAGEMENT INC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.