Healthcare Provider Details

I. General information

NPI: 1902031362
Provider Name (Legal Business Name): SANDRA CARTER AP, DOM, DACM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 HENDERSON BLVD
TAMPA FL
33609-3970
US

IV. Provider business mailing address

2 GLORY LN
ESTANCIA NM
87016-9738
US

V. Phone/Fax

Practice location:
  • Phone: 505-464-5801
  • Fax:
Mailing address:
  • Phone: 505-464-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberLAC-2338
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3388
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: