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NPI Code Detail

MEDICARE: DR SANDRA Y. MITJANS, INC

MEDICARE: DR SANDRA Y. MITJANS, INC
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
1208000000XPediatrics PhysicianME40785FL

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 : 1871994194
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR SANDRA Y. MITJANS, INC
Provider Business Mailing Address
First Line : 700 E 25TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3817
Country : US
Telephone Number : 305-835-0700
Fax Number : 305-696-0963
Provider Business Practice Location Address
First Line : 700 E 25TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3817
Country : US
Telephone Number : 305-835-0700
Fax Number : 305-696-0963
Authorized Official
Title or Position : PRESIDENT
Name : SANDRA YVONNE MITJANS
Credential : MD
Telephone Number : 305-835-0700
Provider Enumeration Date : 09/05/2014
Last Update Date : 09/05/2014

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