Provider Demographics
NPI:1700858891
Name:SANDERS, ALBERT GUY III
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:GUY
Last Name:SANDERS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2576 BOTTOMRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5793
Mailing Address - Country:US
Mailing Address - Phone:904-542-7465
Mailing Address - Fax:904-542-7467
Practice Address - Street 1:NAVAL HOSPITAL, ENT DEPARTMENT
Practice Address - Street 2:2080 CHILD STREET
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-0001
Practice Address - Country:US
Practice Address - Phone:904-542-7048
Practice Address - Fax:904-542-7467
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1058231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist