Provider Demographics
NPI:1518176411
Name:SANDRA SARMIENTO MD PA
Entity Type:Organization
Organization Name:SANDRA SARMIENTO MD PA
Other - Org Name:PROGRESS MEDICAL CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-582-1200
Mailing Address - Street 1:PO BOX 8665
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33075-8665
Mailing Address - Country:US
Mailing Address - Phone:305-984-8330
Mailing Address - Fax:954-582-1205
Practice Address - Street 1:7300 W MCNAB RD STE 113
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5329
Practice Address - Country:US
Practice Address - Phone:954-582-1200
Practice Address - Fax:954-582-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74659261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253533500Medicaid
FL253533500Medicaid