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Organization

SANDRA DEE MD LLC

Active
Parent organization
SANDRA DEE MD LLC
Other names
Stages Pediatrics Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
SANDRA DEE MD LLC
Authorized official
JOCELYN PUA (OFFICE MANAGER)
(856) 577-6888
Entity
Organization

Contact information

Practice address
947 TOWN CENTER DR, ORANGE CITY, FL 32763-8361
(386) 917-0075
(386) 917-0655
Mailing address
947 TOWN CENTER DR, ORANGE CITY, FL 32763-8361
(386) 917-0075
(386) 917-0655

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
261QP2300X
Primary Care Clinic/Center

Other

Enumeration date
08/09/2021
Last updated
08/09/2021
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