Healthcare Provider Details

I. General information

NPI: 1730209958
Provider Name (Legal Business Name): MARIA ILIANA SANDERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7396 SW 117TH AVE
MIAMI FL
33183-3813
US

IV. Provider business mailing address

19278 NW 24TH CT
PEMBROKE PINES FL
33029-5356
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-6207
  • Fax: 305-279-9211
Mailing address:
  • Phone: 786-486-1953
  • Fax: 305-279-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN 834262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: