Provider Demographics
NPI:1811567910
Name:FIGUEROA, SANDRA IVETTE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:IVETTE
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 GUNSTON RD UNIT 1304
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-3543
Mailing Address - Country:US
Mailing Address - Phone:229-460-7707
Mailing Address - Fax:
Practice Address - Street 1:9275 DOERR RD BLDG 1221
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-3160
Practice Address - Country:US
Practice Address - Phone:229-460-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000796-P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical