MEDICARE: NINOSKA SANFORD

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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1578915328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINOSKA SANFORD

Provider Business Mailing Address
First Line	:	2841 WINDSOR HEIGHTS ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2487
Country	:	US
Telephone Number	:	386-500-1976
Fax Number	:

Provider Business Practice Location Address
First Line	:	2841 WINDSOR HEIGHTS ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2487
Country	:	US
Telephone Number	:	386-500-1976
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	02/28/2023

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Directions to “ NINOSKA SANFORD ” Practice Location

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