Healthcare Provider Details

I. General information

NPI: 1588753040
Provider Name (Legal Business Name): DMITRY SANDLER DPM, FACFAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/10/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 NE MIAMI GARDENS DR STE. 280
N. MIAMI BEACH FL
33179-4758
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DR STE. 280
N. MIAMI BEACH FL
33179-4758
US

V. Phone/Fax

Practice location:
  • Phone: 305-735-2022
  • Fax: 305-749-6505
Mailing address:
  • Phone: 305-735-2022
  • Fax: 305-749-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO2931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: