Healthcare Provider Details

I. General information

NPI: 1508834458
Provider Name (Legal Business Name): MICHAEL SANFORD SOFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 SHERIDAN ST
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

4340 SHERIDAN ST
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 954-983-5533
  • Fax: 954-983-6694
Mailing address:
  • Phone: 954-983-5533
  • Fax: 954-983-6694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number54813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: