Healthcare Provider Details

I. General information

NPI: 1740939545
Provider Name (Legal Business Name): CARMEN ESTEFANIA SAINZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 SW PRIMA VISTA BLVD STE 101
PORT ST LUCIE FL
34983-1820
US

IV. Provider business mailing address

672 SW PRIMA VISTA BLVD STE 101
PORT SAINT LUCIE FL
34983-1820
US

V. Phone/Fax

Practice location:
  • Phone: 772-905-2555
  • Fax: 772-336-8153
Mailing address:
  • Phone: 772-905-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS20909
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS20909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: