Healthcare Provider Details

I. General information

NPI: 1104089812
Provider Name (Legal Business Name): SANG HEE MIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER ROAD
GAINESVILLE FL
32610-3001
US

IV. Provider business mailing address

PO BOX 100224
GAINESVILLE FL
32610-0278
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7832
  • Fax:
Mailing address:
  • Phone: 352-273-7832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD443863
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT192249
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME170523
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number4301111224
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: