Healthcare Provider Details

I. General information

NPI: 1386001352
Provider Name (Legal Business Name): MARIANA CAROLINA BOSCAN SANCHEZ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIANA CAROLINA BOSCAN SANCHEZ MD

II. Dates (important events)

Enumeration Date: 01/21/2016
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 RED BUG LAKE RD
OVIEDO FL
32765-6591
US

IV. Provider business mailing address

7560 RED BUG LAKE RD STE 1070
OVIEDO FL
32765-6591
US

V. Phone/Fax

Practice location:
  • Phone: 407-366-4040
  • Fax:
Mailing address:
  • Phone: 407-366-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA10353100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME159866
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: