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General NPI Number Information
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NPI Number | 1477610400
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Entity Type | Organization
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Legal Business Name | SAMMY & DIVINCENZO, PA
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 3003 26TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-3739
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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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Provider Business Mailing Address
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Address Line | 3003 26TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-3739
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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 | OWNER
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Name | RAMDIN V SAMMY
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Credential | D.PM.
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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 |
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License Number State |
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