Michael Clore Sanders, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0051448 Issued in FL

Practice address

301 Health Park Blvd
Suite 327
St Augustine, FL 32086-5771

Phone

(904) 825-3606

Fax

(904) 825-0753

NPI assigned

Aug 1, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1003817040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "SUITE 327",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-825-3606",
            "fax_number": "904-825-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "SUITE 327",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-825-3606",
            "fax_number": "904-825-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MICHAEL",
        "middle_name": "CLORE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0051448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "05969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080012676",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047989600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Sanchez, CSFA
• Carlos Mathieu Sanchez, MD
• Jeffrey Ismael Sanchez, BT
• Kiana Sanchez
• Richard Sanchez
• Itzel Sandoval-Reynoso, PA-C
• Sands Recovery & Wellness LLC
• Erica Sanes, A.P.
• Sanford Clinic North
• Jana Sanford-Heller

• Family Medicine Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.