Healthcare Provider Details

I. General information

NPI: 1265557573
Provider Name (Legal Business Name): SUNANDHA SEKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 S RED RD STE 215
SOUTH MIAMI FL
33143-5408
US

IV. Provider business mailing address

12475 SW 69TH AVE
MIAMI FL
33156-6214
US

V. Phone/Fax

Practice location:
  • Phone: 786-853-9655
  • Fax:
Mailing address:
  • Phone: 305-256-2618
  • Fax: 305-256-2618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME84669
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: