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NPI Code Detail

MEDICARE: DR. NAYIESHA KARIN SANDIFER M.D.

MEDICARE: DR. NAYIESHA KARIN SANDIFER 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1659791739
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAYIESHA KARIN SANDIFER M.D.
Provider Business Mailing Address
First Line : 13515 LAKE TERRACE LN
Second Line :
City : TAMPA
State : FL
Zip : 33637-1003
Country : US
Telephone Number : 813-998-8000
Fax Number :
Provider Business Practice Location Address
First Line : 13515 LAKE TERRACE LN
Second Line :
City : TAMPA
State : FL
Zip : 33637-1003
Country : US
Telephone Number : 813-998-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 07/21/2022

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