Healthcare Provider Details
I. General information
NPI: 1518037399
Provider Name (Legal Business Name): SANCHEZ-CAZAU MEDICAL GROUP, P.A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
777 E 25TH ST STE 109
HIALEAH FL
33013-3804
US
IV. Provider business mailing address
777 E 25TH ST STE 109
HIALEAH FL
33013-3804
US
V. Phone/Fax
- Phone: 305-889-6670
- Fax: 305-889-6671
- Phone: 305-889-6670
- Fax: 305-889-6671
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | ME95970 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
DOLORES
SANCHEZ
CAZAU
Title or Position: PRESIDENT
Credential: MD
Phone: 305-889-6670