Provider Demographics
NPI:1124007497
Name:SAUNDERS, DARRICK T (DO)
Entity Type:Individual
Prefix:
First Name:DARRICK
Middle Name:T
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2666
Mailing Address - Country:US
Mailing Address - Phone:239-772-4484
Mailing Address - Fax:239-772-2903
Practice Address - Street 1:657 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2666
Practice Address - Country:US
Practice Address - Phone:239-772-4484
Practice Address - Fax:239-772-2903
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007507207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57546OtherBCBS FLORIDA
G60297Medicare UPIN
FL99716Medicare ID - Type UnspecifiedGROUP