MR. CHARLES DAVID SANFORD (NPI# 1295773711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295773711 |
| Entity Type | Individual |
| Full Name | MR. CHARLES DAVID SANFORD |
| Credential | P.A. |
| Practice Address |
4801 S Congress Ave Suite 301 Lake Worth FL 33461-4746 |
| Practice Telephone | 5619676500 |
| Practice Fax Number | 5614334175 |
| Mailing Telephone | 5619676500 |
| Mailing Fax Number | 5614334175 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2010-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA 3377 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4801 S CONGRESS AVE SUITE 301 |
| City | LAKE WORTH |
| State | FL |
| Zip Code | 33461-4746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962461640 | David H Kiner | Internal Medicine | 4801 S Congress Ave, Suite 304, Lake Worth, FL 33461-4746 | 2006-03-21 |
| 1558719526 | Soho Wellness Initiative, LLC | Clinic/Center | 4801 S Congress Ave, Suite 120, Lake Worth, FL 33461-4746 | 2016-05-31 |
| 1326417676 | Soho Wellness Initiative, LLC | Clinic/Center | 4801 S Congress Ave, Suite 120, Lake Worth, FL 33461-4746 | 2015-09-16 |
| 1326399791 | Blue Water Doctors of Lake Worth LLC | Family Medicine | 4801 S Congress Ave, Suite 304, Lake Worth, FL 33461-4746 | 2012-09-26 |
| 1508147240 | Wellington Orthopedic Institute | Orthopaedic Surgery | 4801 S Congress Ave, Lake Worth, FL 33461-4746 | 2011-09-08 |
| 1790095693 | Dr David H Kiner Do Pa | Internal Medicine | 4801 S Congress Ave, Suite 304, Lake Worth, FL 33461-4746 | 2010-10-14 |
| 1558680991 | Dennis Montoya | Physical Therapist | 4801 S Congress Ave, Lake Worth, FL 33461-4746 | 2010-05-25 |
| 1396077210 | Sarah Oliver | Specialist/Technologist | 4801 S Congress Ave, Lake Worth, FL 33461-4746 | 2010-02-02 |
| 1154595023 | Conte's Dental Group | Dentist | 4801 S Congress Ave, Lake Worth, FL 33461-4746 | 2008-04-22 |
| 1306018858 | Audrey E Sawney-young | Occupational Therapy Assistant | 4801 S Congress Ave, Lake Worth, FL 33461-4746 | 2008-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167993 | Pcc Medical Holdings LLC | Health Maintenance Organization | 5055 South Congress Avenue, Suite 303, Lake Worth, FL 33461 | 2019-11-05 |
| 1841849692 | Five Star Medical Group Inc | Clinic/Center | 4300 10th Ave North, Suite 2, Lake Worth, FL 33461 | 2019-09-04 |
| 1346894375 | Patrick Pierre Jr. | Behavioral Analyst | 2430 Lake Worth Rd, Apt 2306, Lake Worth, FL 33461 | 2019-07-29 |
| 1740842699 | Amanda Shaw | Massage Therapist | 822 Lynnwood Dr, Lake Worth, FL 33461 | 2019-07-01 |
| 1043706005 | Elina Aguero Arman | Case Manager/Care Coordinator | 420 Alemeda Dr, Palm Springs, FL 33461 | 2018-07-02 |
| 1275028656 | Cagigas Dental Services Inc | Clinic/Center | 2311 10th Avenue North Suite 14, Lake Worth, FL 33461 | 2018-06-27 |
| 1972028447 | Annette Daley | Behavior Technician | 3595 2nd Ave North, Palm Springs, FL 33461 | 2017-08-07 |
| 1104349471 | Safe At Home Health Care, LLC | In Home Supportive Care | 555 Purdy Ln. #215, Palm Springs, FL 33461 | 2017-07-19 |
| 1609307271 | Yadira Perera | Assistant Behavior Analyst | 500 Davis Rd 42a, Palm Springs, FL 33461 | 2017-03-24 |
| 1982155842 | Palm Beach Addiction Center, Inc | Substance Abuse Rehabilitation Facility | 4196 Lake Worth Road, Lake Worth, FL 33461 | 2016-10-17 |
| Find all providers in zip 33461 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
| 1194389361 | John Santoro | Physician Assistant | 10628 Paso Fino Dr, Lake Worth, FL 33449-8018 | 2019-04-23 |
| 1043536402 | On Call, Inc | Physician Assistant | 6660 Ashburn Rd, Lake Worth, FL 33467-7316 | 2010-04-10 |
| 1548273097 | Oscar J Ordenana | Physician Assistant | 1926 10th Ave N Ste 105, Lake Worth, FL 33461-3300 | 2006-08-15 |
| 1710513056 | West Palm Beach Surgical Assisting LLC | Physician Assistant | 10628 Paso Fino Dr, Lake Worth, FL 33449-8018 | 2020-03-18 |
| 1770117830 | Monica Tirtarahardja | Physician Assistant | 5503 S Congress Ave Ste 204, Lake Worth, FL 33462-6626 | 2020-02-27 |
| 1831747427 | Jose Munoz Surgical Assistant Services LLC | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-28 |
| 1457895161 | Shannen Marie Seversen | Physician Assistant | 3618 Lantana Road, Suite 200, Lake Worth, FL 33462-2247 | 2016-12-14 |
| 1023401023 | Heather Vangeldren Rnfa Services Inc | Physician Assistant | 7615 Woodland Creek Ln, Lake Worth, FL 33467-6522 | 2015-03-15 |
| 1659650620 | Stephanie L Ferrer | Physician Assistant | 4685 S Congress Ave, Suite 201, Lake Worth, FL 33461-4761 | 2011-08-09 |
| Find all providers in LAKE WORTH | ||||
| City | LAKE WORTH |
| Zip Code | 33461 |
Please comment or provide details below to improve the information on MR. CHARLES DAVID SANFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.