Individual
SUSAN SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
430 E CENTRAL AVE, WINTER HAVEN, FL 33880-3050
(863) 284-6850
(863) 284-6853
Mailing address
1324 LAKELAND HILLS BLVD, MEDICAL STAFF OFFICE, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME76434
FL
Other
Enumeration date
06/21/2005
Last updated
07/21/2022
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