MEDICARE: SANDERS COMPREHENSIVE CLINIC

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
1	363LF0000X	Family Nurse Practitioner	2602032	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538446414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDERS COMPREHENSIVE CLINIC

Provider Business Mailing Address
First Line	:	7750 PALM RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4215
Country	:	US
Telephone Number	:	813-635-9611
Fax Number	:	813-635-0211

Provider Business Practice Location Address
First Line	:	7750 PALM RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4215
Country	:	US
Telephone Number	:	813-635-9611
Fax Number	:	813-635-0211

Authorized Official
Title or Position	:	CEO
Name	:	SANDRA ELAINE FFRENCH-ROSE
Credential	:	ARNP
Telephone Number	:	813-635-9611

Provider Enumeration Date	:	11/07/2011
Last Update Date	:	11/07/2011

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Directions to “SANDERS COMPREHENSIVE CLINIC ” Practice Location

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