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General NPI Number Information
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NPI Number | 1851554547
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Entity Type | Organization
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Legal Business Name | ROBERT C SANFORD ARNP PL
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 09/07/2008
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Provider Practice Location Address
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Address Line | 303 75TH STREET CT NW
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City | BRADENTON
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State | FL
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Zip | 34209-7221
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Country | US
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Telephone | 941-518-5219
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Fax | 941-795-0748
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Provider Business Mailing Address
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Address Line | 303 75TH STREET CT NW
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City | BRADENTON
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State | FL
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Zip | 34209-7221
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Country | US
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Telephone | 941-518-5219
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Fax | 941-795-0748
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. ROBERT C. SANFORD
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Credential | ARNP
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Telephone | 941-518-5219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9202171
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License Number State | FL
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