Healthcare Provider Details

I. General information

NPI: 1962473017
Provider Name (Legal Business Name): RICHARD EDWARD SANDROW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 SW 88TH ST STE 1003E
MIAMI FL
33176-2178
US

IV. Provider business mailing address

8940 SW 88TH ST STE 1003E
MIAMI FL
33176-2178
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-2550
  • Fax: 305-595-2555
Mailing address:
  • Phone: 305-595-2550
  • Fax: 305-595-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0016459
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: