Provider Demographics
NPI:1235226853
Name:SANCETTA, RONALD AUGUSTINE (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:AUGUSTINE
Last Name:SANCETTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9275 SW 152ND ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1701
Mailing Address - Country:US
Mailing Address - Phone:305-253-8700
Mailing Address - Fax:305-253-2586
Practice Address - Street 1:9275 SW 152ND ST
Practice Address - Street 2:SUITE 208
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1701
Practice Address - Country:US
Practice Address - Phone:305-253-8700
Practice Address - Fax:305-253-2586
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046577207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08181Medicare ID - Type Unspecified
FLE22428Medicare UPIN