Provider Demographics
NPI:1144454224
Name:SANJENIS, LOURDES ROSA (MD)
Entity type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:ROSA
Last Name:SANJENIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STAR ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5147
Mailing Address - Country:US
Mailing Address - Phone:305-793-4491
Mailing Address - Fax:305-538-3243
Practice Address - Street 1:730 NW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3344
Practice Address - Country:US
Practice Address - Phone:305-635-1335
Practice Address - Fax:305-635-2859
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine