Individual provider Active NPI

Marina Penteado Sandoval, M.D., PH.D.

  • Dermatopathology (Pathology) Physician
  • Pompano Beach, FL
National Provider Identifier
1487978862
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
ME116387 Issued in FL
Practice address
895 SW 30TH Ave Ste 101
Pompano Beach, FL 33069-4887
Phone
(310) 809-7432
Fax
(954) 633-3465
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X ME116387 FL Primary

Addresses

Primary practice location

895 SW 30TH Ave Ste 101
Pompano Beach, FL 33069-4887

Mailing address

1511 NW 92ND Way
Coral Springs, FL 33071-6035
Phone (310) 809-7432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ME116387FLMDDermatopathology (Pathology) Physician

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1487978862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 NW 92ND WAY",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716035",
            "telephone_number": "310-809-7432",
            "fax_number": "954-633-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 SW 30TH AVE STE 101",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330694887",
            "telephone_number": "310-809-7432",
            "fax_number": "954-633-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "MARINA",
        "middle_name": "PENTEADO",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME116387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.