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NPI Code Detail

MEDICARE: SCOTT ALLEN SANFORD M.D.

MEDICARE: SCOTT ALLEN SANFORD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME63841FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1592770836OTHERFLTAX ID FOR TRICARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497754725
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT ALLEN SANFORD M.D.
Provider Business Mailing Address
First Line : 5550 S US HIGHWAY 1
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-8701
Country : US
Telephone Number : 772-460-9227
Fax Number : 772-460-9292
Provider Business Practice Location Address
First Line : 5550 S US HIGHWAY 1
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-8701
Country : US
Telephone Number : 772-460-9227
Fax Number : 772-460-9292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 07/02/2019

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Directions to “ SCOTT ALLEN SANFORD M.D.” Practice Location

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