Healthcare Provider Details

I. General information

NPI: 1114917697
Provider Name (Legal Business Name): JOANNE M SARROZA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD STE 312
AVENTURA FL
33180-1229
US

IV. Provider business mailing address

PO BOX 9100
BELFAST ME
04915-9100
US

V. Phone/Fax

Practice location:
  • Phone: 305-933-3030
  • Fax: 305-933-1436
Mailing address:
  • Phone: 613-002-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS18864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: