Provider Demographics
NPI:1467724468
Name:BRENDA SANZOBRINO PLLC
Entity Type:Organization
Organization Name:BRENDA SANZOBRINO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANZOBRINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-962-7200
Mailing Address - Street 1:1779 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-0929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1779 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-0929
Practice Address - Country:US
Practice Address - Phone:954-962-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371098000Medicaid
FL17706SMedicare PIN