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NPI Code Detail

MEDICARE: DAVID SANJUAN MD

MEDICARE: DAVID SANJUAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician15442PR
2208D00000XGeneral Practice PhysicianACN1047FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3PV866OTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ACN1047OTHERFLSTATE LICENSE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306270509
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID SANJUAN MD
Provider Business Mailing Address
First Line : 737 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-3121
Country : US
Telephone Number : 321-247-4960
Fax Number : 833-963-0116
Provider Business Practice Location Address
First Line : 737 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-3121
Country : US
Telephone Number : 321-247-4960
Fax Number : 833-963-0116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2013
Last Update Date : 03/07/2023

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Directions to “ DAVID SANJUAN MD” Practice Location

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