Healthcare Provider Details

I. General information

NPI: 1992368385
Provider Name (Legal Business Name): PALOMA SARDINA MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2879 N NARCOOSSEE RD
SAINT CLOUD FL
34771-8781
US

IV. Provider business mailing address

2879 N NARCOOSSEE RD
SAINT CLOUD FL
34771-8781
US

V. Phone/Fax

Practice location:
  • Phone: 689-588-5588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME169904
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number317495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: