Provider Demographics
NPI:1316127285
Name:LUIS F SABOGAL, MDPA
Entity type:Organization
Organization Name:LUIS F SABOGAL, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:SABOGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-445-2404
Mailing Address - Street 1:1800 SW 27TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2457
Mailing Address - Country:US
Mailing Address - Phone:305-445-2404
Mailing Address - Fax:305-443-8759
Practice Address - Street 1:1800 SW 27TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2457
Practice Address - Country:US
Practice Address - Phone:305-445-2404
Practice Address - Fax:305-443-8759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072083208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5386Medicare PIN