Provider Demographics
NPI:1730642554
Name:SAINVILUS, MARTINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTINE
Middle Name:S
Last Name:SAINVILUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W OAK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6605
Mailing Address - Country:US
Mailing Address - Phone:407-846-3455
Mailing Address - Fax:407-846-3670
Practice Address - Street 1:801 W OAK STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-846-3455
Practice Address - Fax:407-846-3670
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155741208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114852500Medicaid