Individual
SANDRA HEGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
4300 KINGS HWY, #500, PORT CHARLOTTE, FL 33980-2917
(239) 344-2325
(941) 764-6176
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME83768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000805000
—
FL
Enumeration date
12/15/2008
Last updated
09/30/2020
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