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General NPI Number Information
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NPI Number | 1225902075
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Entity Type | Organization
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Legal Business Name | SANFORD FAMILY CARE CENTER, LLC
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 2200 S FRENCH AVE # 10031004
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City | SANFORD
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State | FL
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Zip | 32771-4253
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Country | US
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Telephone | 407-710-0060
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Fax | 833-973-5852
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Provider Business Mailing Address
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Address Line | 101 PINEFIELD DR # 10031004
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City | SANFORD
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State | FL
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Zip | 32771-6811
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Country | US
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Telephone | 407-710-0060
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Fax | 833-973-5852
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTLE MARTIN
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Credential |
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Telephone | 407-712-3391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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