Provider Demographics
NPI:1578903068
Name:SANJAY, MERIN P (NP)
Entity Type:Individual
Prefix:MRS
First Name:MERIN
Middle Name:P
Last Name:SANJAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 TUSCANY WAY
Mailing Address - Street 2:APT # 206
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8156
Mailing Address - Country:US
Mailing Address - Phone:215-262-3698
Mailing Address - Fax:
Practice Address - Street 1:1301 CONCORD TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2843
Practice Address - Country:US
Practice Address - Phone:800-243-3839
Practice Address - Fax:954-851-1840
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9361211363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal