MEDICARE: CHRISTIAN E SANON

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	207Q00000X	Family Medicine Physician	NJDCATEMP598	NJ

General Provider Information

NPI Number	:	1841829512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN E SANON

Provider Business Mailing Address
First Line	:	1690 RENAISSANCE COMMONS BLVD APT 1301
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-7211
Country	:	US
Telephone Number	:	561-633-0034
Fax Number	:

Provider Business Practice Location Address
First Line	:	1690 RENAISSANCE COMMONS BLVD APT 1301
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-7211
Country	:	US
Telephone Number	:	561-644-9252
Fax Number	:

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

Provider Enumeration Date	:	04/05/2020
Last Update Date	:	04/05/2020

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