1629183249 NPI number — DR. ALMA ROSA SANJUR DO

Table of content: DR. ALMA ROSA SANJUR DO (NPI 1629183249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629183249 NPI number — DR. ALMA ROSA SANJUR DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANJUR
Provider First Name:
ALMA
Provider Middle Name:
ROSA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629183249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 ARTHUR GODFREY ROAD
Provider Second Line Business Mailing Address:
SUITE 501
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-531-8643
Provider Business Mailing Address Fax Number:
305-531-7221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
975 ARTHUR GODFREY ROAD
Provider Second Line Business Practice Location Address:
SUITE 501
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-531-8643
Provider Business Practice Location Address Fax Number:
305-531-7221
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  050005954 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 255246900 . This is a "MEDICAID MEDIPASS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "GREAT WESTERN HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2712620 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "GREAT-WEST HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9345 . This is a "TOTAL HEALTH CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "BEECHSTREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2555246900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 278952 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "BCBS HEALTH OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37097 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80652 . This is a "BLUE CROSS BLUE SHIELD OF" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "PREFERRED CARE PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651123616 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".




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