Provider Demographics
NPI:1831256809
Name:SANJORGE, ANTONIA ROSA (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:ROSA
Last Name:SANJORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6920 SW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4640
Mailing Address - Country:US
Mailing Address - Phone:305-273-0026
Mailing Address - Fax:305-273-0388
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:SUITE 603E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-273-0026
Practice Address - Fax:305-273-0388
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME565162080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF35118Medicare UPIN
FL17846Medicare ID - Type Unspecified