Provider Demographics
NPI:1598637183
Name:SARDINAS HERRERA, LUIS AGUSTIN
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:AGUSTIN
Last Name:SARDINAS HERRERA
Suffix:
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 1:2049 41ST ST SW APT B
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6565
Mailing Address - Country:US
Mailing Address - Phone:239-399-2029
Mailing Address - Fax:
Practice Address - Street 1:2049 41ST ST SW APT B
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6565
Practice Address - Country:US
Practice Address - Phone:239-399-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician