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NPI Code Detail

MEDICARE: DR. TIMOTHY GENE SANDERS M.D.

MEDICARE: DR. TIMOTHY GENE SANDERS M.D.
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
12085R0202XDiagnostic Radiology PhysicianE-4403AR
22085R0202XDiagnostic Radiology PhysicianL4691TX
32085R0202XDiagnostic Radiology Physician37100AZ
42085R0202XDiagnostic Radiology Physician4301507775MI
52085R0202XDiagnostic Radiology Physician60421FL
62085R0202XDiagnostic Radiology Physician0101235012VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205818127
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY GENE SANDERS M.D.
Provider Business Mailing Address
First Line : 629A E HILLSBORO BLVD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-3517
Country : US
Telephone Number : 954-698-9399
Fax Number : 954-698-6963
Provider Business Practice Location Address
First Line : 629A E HILLSBORO BLVD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-3517
Country : US
Telephone Number : 954-698-9399
Fax Number : 954-698-6963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 03/19/2024

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