Healthcare Provider Details

I. General information

NPI: 1194775817
Provider Name (Legal Business Name): MANUEL C SAINZ DE LA PENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 WEST MARTIN LUTHER KING BLVD 450
TAMPA FL
33607-6002
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-875-8453
  • Fax: 813-377-1390
Mailing address:
  • Phone: 813-528-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME0055381
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: