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General NPI Number Information
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NPI Number | 1457544025
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Entity Type | Organization
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Legal Business Name | SAMMY & DIVINCENZO, P.A.
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 7210 US HIGHWAY 301 N
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City | ELLENTON
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State | FL
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Zip | 34222-3444
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Country | US
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Telephone | 941-729-5588
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Fax | 941-729-0012
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Provider Business Mailing Address
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Address Line | 7210 US HIGHWAY 301 N
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City | ELLENTON
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State | FL
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Zip | 34222-3444
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Country | US
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Telephone | 941-753-1234
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Fax | 941-755-1332
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHARON J HOEK
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Credential |
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Telephone | 941-753-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO1826
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License Number State | FL
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