Organization
AGUSTIN C SANZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA SANZ (ADMINISTRATOR)
(772) 879-4667
Entity
Organization
Contact information
Practice address
1420 SW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1709
(772) 879-4667
(772) 879-4478
Mailing address
1420 SW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1709
(772) 879-4667
(772) 879-4478
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME63215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18918
—
FL
Enumeration date
12/02/2010
Last updated
01/06/2011
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