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SANDRA DEE MD LLC NPI 1477881829


NPI Information

NPI: 1477881829
Provider Name: SANDRA DEE MD LLC

Doing Business As: STAGES PEDIATRIC CARE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D1071295

Address:
947 TOWN CENTER DR
ORANGE CITY, FL
ZIP 32763
Phone: (386) 917-0075
Get Directions

SANDRA DEE MD LLC is a pediatrics in Orange City, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SANDRA DEE MD LLC NPI is 1477881829. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Stages Pediatric Care.

The provider's business location address is:

947 TOWN CENTER DR
ORANGE CITY, FL
ZIP 32763-361
Phone: (386) 917-0075
Fax: (386) 917-0655

The provider's authorized official is Sandra Dee .
The authorized official title is Physician and has the following contact phone number (386) 917-0075.

The CLIA number assigned to this NPI record is 10D1071295 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2009 and was last updated on 9/7/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsME96074FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1277419400MEDICAIDFLORIDA
2ME96074OTHERFLORIDASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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