Active NPI
Stanley Sack MD PA
- Pediatrics Physician
- Key West, FL
National Provider Identifier
1669648077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 86306
- Legal business name
- STANLEY SACK MD PA
- Practice address
- 1201 White St
Suite 103
Key West, FL 33040-3328 - Phone
- (305) 295-7337
- Fax
- (305) 295-0597
- NPI assigned
- May 6, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stanley Sinclair Sack, MD
- Title
- President
- Phone
- (305) 292-0598
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME 86306 | FL | Primary |
Addresses
Primary practice location
1201 White St
Suite 103
Key West, FL 33040-3328
Mailing address
1201 White St
Suite 103
Key West, FL 33040-3328
Phone (305) 295-7337
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58498 | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
| 276711200 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
1201 White St
Ste 103
Key West, FL 33040
Phone (305) 295-0598
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Key West, FL
- NPI 1962429449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225238400000",
"number": "1669648077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 WHITE ST",
"address_2": "SUITE 103",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403328",
"telephone_number": "305-295-7337",
"fax_number": "305-295-0597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 WHITE ST",
"address_2": "SUITE 103",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403328",
"telephone_number": "305-295-7337",
"fax_number": "305-295-0597"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STANLEY SACK MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-06",
"last_updated": "2008-10-29",
"status": "A",
"authorized_official_last_name": "SACK",
"authorized_official_first_name": "STANLEY",
"authorized_official_middle_name": "SINCLAIR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "305-292-0598",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 86306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
"identifier": "58498",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276711200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Key West, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.