Provider Demographics
NPI:1629183249
Name:SANJUR, ALMA ROSA (DO)
Entity Type:Individual
Prefix:DR
First Name:ALMA
Middle Name:ROSA
Last Name:SANJUR
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:975 ARTHUR GODFREY ROAD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-531-8643
Mailing Address - Fax:305-531-7221
Practice Address - Street 1:975 ARTHUR GODFREY ROAD
Practice Address - Street 2:SUITE 501
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-531-8643
Practice Address - Fax:305-531-7221
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL050005954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
255246900OtherMEDICAID MEDIPASS
651123616OtherAMERIGROUP
651123616OtherGREAT WESTERN HEALTHCARE
2712620OtherAETNA
651123616OtherGREAT-WEST HEALTHCARE
9345OtherTOTAL HEALTH CHOICE
651123616OtherBEECHSTREET
651123616OtherFIRST HEALTH
FL2555246900Medicaid
278952OtherAVMED
651123616OtherBCBS HEALTH OPTIONS
651123616OtherCIGNA
37097OtherNHP
FL80652OtherBLUE CROSS BLUE SHIELD OF
651123616OtherPREFERRED CARE PARTNERS
651123616OtherUNITED HEALTHCARE
651123616OtherPHCS
651123616OtherBCBS HEALTH OPTIONS
255246900OtherMEDICAID MEDIPASS
278952OtherAVMED