Provider Demographics
NPI:1518904382
Name:SANZOBRINO, BRENDA W (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:W
Last Name:SANZOBRINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1779 N UNIVERSITY DR
Mailing Address - Street 2:204
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-0929
Mailing Address - Country:US
Mailing Address - Phone:954-962-7200
Mailing Address - Fax:954-893-5936
Practice Address - Street 1:1779 N UNIVERSITY DR
Practice Address - Street 2:204
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:954-893-5936
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 62521207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371098000Medicaid
FL371098000Medicaid