MEDICARE: JULIO SANGUILY III 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
1	2086S0129X	Vascular Surgery Physician	ME61666	FL

General Provider Information

NPI Number	:	1699783241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO SANGUILY III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34995-0417
Country	:	US
Telephone Number	:	772-223-5665
Fax Number	:	772-223-5646

Provider Business Practice Location Address
First Line	:	2580 METROCENTRE BLVD
Second Line	:	STE 3
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3100
Country	:	US
Telephone Number	:	561-594-1840
Fax Number	:	800-906-3055

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	08/10/2023

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