Basic Information
Provider Information
NPI: 1669446613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARANITA
FirstName: ANTHONY
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3165 MCCRORY PL
Address2: STE 174
City: ORLANDO
State: FL
PostalCode: 328033727
CountryCode: US
TelephoneNumber: 4074231234
FaxNumber: 4075171040
Practice Location
Address1: 1381 CITRUS TOWER BLVD
Address2: STE 103
City: CLERMONT
State: FL
PostalCode: 347111957
CountryCode: US
TelephoneNumber: 3522437066
FaxNumber: 3522437068
Other Information
ProviderEnumerationDate: 02/15/2006
LastUpdateDate: 09/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213ES0103XPO 2917FLY Podiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery

ID Information
IDTypeStateIssuerDescription
34054510005FL MEDICAID
P0026831501FLR/R MEDICAREOTHER


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