Provider Demographics
NPI:1609897305
Name:MENENDEZ-APONTE, SERGIO L (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:L
Last Name:MENENDEZ-APONTE
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 1:120 BENMORE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4101
Mailing Address - Country:US
Mailing Address - Phone:407-645-5998
Mailing Address - Fax:407-645-3301
Practice Address - Street 1:120 BENMORE DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4101
Practice Address - Country:US
Practice Address - Phone:407-645-5998
Practice Address - Fax:407-645-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-48035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12400Medicare PIN
FLE-21246Medicare UPIN
FL12400YMedicare PIN