Healthcare Provider Details

I. General information

NPI: 1730284860
Provider Name (Legal Business Name): CARON FELICE SANUA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 PGA BLVD STE 300
PALM BEACH GARDENS FL
33410-2824
US

IV. Provider business mailing address

3401 PGA BLVD STE 300
PALM BEACH GARDENS FL
33410-2824
US

V. Phone/Fax

Practice location:
  • Phone: 561-741-0000
  • Fax: 561-627-0040
Mailing address:
  • Phone: 561-741-0000
  • Fax: 561-627-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME66241
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: