Provider Demographics
NPI:1689768491
Name:SANDERSON, DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2220 SE OCEAN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3301
Mailing Address - Country:US
Mailing Address - Phone:772-872-6913
Mailing Address - Fax:772-872-6924
Practice Address - Street 1:2220 SE OCEAN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3301
Practice Address - Country:US
Practice Address - Phone:772-872-6913
Practice Address - Fax:772-872-6924
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97068208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery