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NPI Code Detail

MEDICARE: SANDRO BACCHELLI MD

MEDICARE: SANDRO BACCHELLI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME60666FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134106487
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRO BACCHELLI MD
Provider Business Mailing Address
First Line : 750 S FEDERAL HWY
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-5424
Country : US
Telephone Number : 954-342-8800
Fax Number : 954-342-8700
Provider Business Practice Location Address
First Line : 750 S FEDERAL HWY
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-5424
Country : US
Telephone Number : 954-342-8800
Fax Number : 954-342-8700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 03/05/2008

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Directions to “ SANDRO BACCHELLI MD” Practice Location

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