Healthcare Provider Details

I. General information

NPI: 1992863740
Provider Name (Legal Business Name): MARIA CARLOTA SANJORGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 RCA BLVD STE 113
PALM BEACH GARDENS FL
33410-3337
US

IV. Provider business mailing address

1070 SIENA OAKS CIR E
PALM BEACH GARDENS FL
33410-5134
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-5790
  • Fax: 561-626-6205
Mailing address:
  • Phone: 561-627-1442
  • Fax: 561-626-6205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 49290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: