Healthcare Provider Details

I. General information

NPI: 1306099304
Provider Name (Legal Business Name): JUAN ENRIQUE SARDINA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 BURNS RD STE 101
PALM BEACH GARDENS FL
33410-4360
US

IV. Provider business mailing address

PO BOX 20800
BELFAST ME
04915-4105
US

V. Phone/Fax

Practice location:
  • Phone: 561-806-0709
  • Fax: 561-828-3163
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 3468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: