Provider Demographics
NPI:1316523343
Name:SANZ, SABASTIANA MARIA (MD)
Entity type:Individual
Prefix:
First Name:SABASTIANA
Middle Name:MARIA
Last Name:SANZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10258 GUATEMALA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4665
Mailing Address - Country:US
Mailing Address - Phone:954-665-9669
Mailing Address - Fax:
Practice Address - Street 1:10258 GUATEMALA ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-4665
Practice Address - Country:US
Practice Address - Phone:954-665-9669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME167201207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program