Provider Demographics
NPI:1962719161
Name:DOCTOR VISIT, P.A.
Entity type:Organization
Organization Name:DOCTOR VISIT, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-450-7172
Mailing Address - Street 1:20191 E COUNTRY CLUB DR
Mailing Address - Street 2:APT 2111
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3012
Mailing Address - Country:US
Mailing Address - Phone:954-224-8737
Mailing Address - Fax:305-937-4022
Practice Address - Street 1:20191 E COUNTRY CLUB DR
Practice Address - Street 2:APT 2111
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3012
Practice Address - Country:US
Practice Address - Phone:954-224-8737
Practice Address - Fax:305-937-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59745207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty