Healthcare Provider Details

I. General information

NPI: 1457606923
Provider Name (Legal Business Name): MARTHA A SARDO M.EDU.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2476 DAMMAR ST
ORLANDO FL
32824-4511
US

IV. Provider business mailing address

2476 DAMMAR ST
ORLANDO FL
32824-4511
US

V. Phone/Fax

Practice location:
  • Phone: 321-305-8523
  • Fax: 866-834-7547
Mailing address:
  • Phone: 321-305-8523
  • Fax: 866-834-7547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberNO LICENSE NUMBER
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: