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Organization
SANFORD MEDICAL GROUP, PA
Active
Organization
SANFORD MEDICAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINAY CHANDRA SRIVASTAVA M.D. (PRESIDENT)
(407) 322-4431
Entity
Organization
Contact information
Practice address
1621 W 1ST ST, SANFORD, FL 32771-1617
(407) 322-4431
(407) 322-4448
Mailing address
1621 W 1ST ST, P.O. BOX 848, SANFORD, FL 32772-0848
(407) 322-4431
(407) 322-4448
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME93082
FL
Other
Enumeration date
07/30/2006
Last updated
08/22/2020
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