Healthcare Provider Details

I. General information

NPI: 1689038366
Provider Name (Legal Business Name): MARTHA SORAYA SANCHEZ LANDAZABAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 LYONS RD STE 110
COCONUT CREEK FL
33073-3481
US

IV. Provider business mailing address

4570 LYONS RD STE 110
COCONUT CREEK FL
33073-3481
US

V. Phone/Fax

Practice location:
  • Phone: 954-971-3210
  • Fax:
Mailing address:
  • Phone: 954-971-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME139870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: