Provider Demographics
NPI:1073799417
Name:SARDO, MARGO MAE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:MAE
Last Name:SARDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10549
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0549
Mailing Address - Country:US
Mailing Address - Phone:727-544-2284
Mailing Address - Fax:727-541-7984
Practice Address - Street 1:5 DAYTON RD STE 102
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4279
Practice Address - Country:US
Practice Address - Phone:860-271-2400
Practice Address - Fax:860-437-1006
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1073799417Medicaid
FL005543600Medicaid