# SANJAY SASTRY MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891315859
- **Authorized official:** SANJAY SASTRY MD (OWNER)
- **Authorized official phone:** (407) 280-3630

## Contact information

- **Practice address:** 612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
- **Practice address phone:** (386) 423-5500
- **Mailing address:** 612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
- **Mailing address phone:** (386) 423-5500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/20/2020
- **Last updated:** 04/20/2020