Sanford Medical Group, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME93082 Issued in FL

Legal business name

SANFORD MEDICAL GROUP, PA

Practice address

1621 W 1St St
Sanford, FL 32771-1617

Phone

(407) 322-4431

Fax

(407) 322-4448

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vinay Chandra Srivastava, M.D.

Title

President

Phone

(407) 322-4431

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801801501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 W 1ST ST",
            "address_2": "P.O. BOX 848",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327720848",
            "telephone_number": "407-322-4431",
            "fax_number": "407-322-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W 1ST ST",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711617",
            "telephone_number": "407-322-4431",
            "fax_number": "407-322-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "VINAY",
        "authorized_official_middle_name": "CHANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-322-4431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME93082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mekeshia Shanquietta Sanchez, APRN, FNP-C
• Raquel Sanchez, M.ED.
• Sanford Family Care Center, LLC
• Sanford Family Dentistry
• Sanford Gentle Dentistry
• Sanford Orthopedic & Rehabilitation
• Sanford Pain and Wellness Center Inc
• Sanford Pelvic Therapy and Wellness LLC
• Sanford Pharmacy Inc
• Sanford PL LLC

• Internal Medicine Physician in Sanford, FL
• Providers in Sanford, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.