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General NPI Number Information
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NPI Number | 1407227556
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Entity Type | Individual
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Provider Name | MARIELA SANDI PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 3311 PRESCOTT RD STE 100
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3917
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Country | US
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Telephone | 318-442-3384
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Fax | 318-442-3385
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Provider Business Mailing Address
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Address Line | 2160 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1410
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9109078
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 340042
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License Number State | LA
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