Healthcare Provider Details

I. General information

NPI: 1023049061
Provider Name (Legal Business Name): LUIS E. SANZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR SUITE 475
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

1625 N GEORGE MASON DR SUITE 475
ARLINGTON VA
22205-3683
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4000
  • Fax: 703-717-4009
Mailing address:
  • Phone: 703-717-4000
  • Fax: 703-717-4009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101029040
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number0101029040
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: