Healthcare Provider Details

I. General information

NPI: 1164220125
Provider Name (Legal Business Name): SANITAS OCOEE IDTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8849 W COLONIAL DR
OCOEE FL
34761-6951
US

IV. Provider business mailing address

8400 NW 33RD ST
DORAL FL
33122-2008
US

V. Phone/Fax

Practice location:
  • Phone: 407-926-1245
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAYRA G TORRES
Title or Position: CFO
Credential:
Phone: 718-918-2370