Basic Information
Provider Information
NPI: 1760470223
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAAVEDRA
FirstName: JOSEPH
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5840 W CYPRESS ST
Address2: B
City: TAMPA
State: FL
PostalCode: 336077004
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Practice Location
Address1: 5840 W CYPRESS ST
Address2: B
City: TAMPA
State: FL
PostalCode: 336077004
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Other Information
ProviderEnumerationDate: 10/10/2005
LastUpdateDate: 10/17/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XME0047397FLY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
06283870105FL MEDICAID


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