Provider Demographics
NPI:1457126518
Name:SAINT PHARD, ESTEPHAT (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTEPHAT
Middle Name:
Last Name:SAINT PHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 ANGLER DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2355
Mailing Address - Country:US
Mailing Address - Phone:561-574-3382
Mailing Address - Fax:
Practice Address - Street 1:23 CALLE PADRE BERRIOS
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1644
Practice Address - Country:US
Practice Address - Phone:787-857-4949
Practice Address - Fax:787-857-4949
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1497363A00000X
WI21-277246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty