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Sandra Dee MD LLC

Pediatrics in Orange City, FL. Organization (NPI-2).

NPI number1972277333
StatusActive
Last updated in NPPESAug 9, 2021

Details

NPI
1972277333
Entity type
Organization (NPI-2)
Legal business name
Sandra Dee MD LLC
Organization subpart
Yes
Enumeration date
Aug 9, 2021
Certification date
Jul 13, 2021
Last updated
Aug 9, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208000000X Pediatrics––Yes
261QP2300X Clinic/Center, Primary Care––

Other names

  • Stages Pediatrics Care (Doing Business As)

Practice location

947 Town Center Dr
Orange City, FL 32763-8361

Phone 386-917-0075 · Fax 386-917-0655

Mailing address

947 Town Center Dr
Orange City, FL 32763-8361

Phone 386-917-0075 · Fax 386-917-0655

Authorized official

Jocelyn Pua
Office Manager
8565776888

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