Healthcare Provider Details

I. General information

NPI: 1730408147
Provider Name (Legal Business Name): ANTONIOS PAPANICOLAU-SENGOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WASHINGTON ST
HOLLYWOOD FL
33021-8216
US

IV. Provider business mailing address

9581 PREMIER PKWY
MIRAMAR FL
33025-3206
US

V. Phone/Fax

Practice location:
  • Phone: 954-966-4500
  • Fax:
Mailing address:
  • Phone: 954-276-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME162921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: