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General NPI Number Information
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NPI Number | 1477881829
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Entity Type | Organization
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Legal Business Name | SANDRA DEE MD LLC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 947 TOWN CENTER DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-8361
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Country | US
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Telephone | 386-917-0075
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Fax | 386-917-0655
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Provider Business Mailing Address
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Address Line | 947 TOWN CENTER DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-8361
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Country | US
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Telephone | 386-917-0075
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Fax | 386-917-0655
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SANDRA DEE
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Credential | MD
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Telephone | 386-917-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME96074
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License Number State | FL
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