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General NPI Number Information
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NPI Number | 1023725231
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Entity Type | Organization
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Legal Business Name | AMANDA SANFORD OD LLC
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Dates
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Enumeration Date | 10/28/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 12331 SW 3RD ST STE 300
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City | PLANTATION
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State | FL
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Zip | 33325-2815
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Country | US
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Telephone | 605-690-8580
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Fax |
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Provider Business Mailing Address
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Address Line | 12331 SW 3RD ST STE 300
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City | PLANTATION
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State | FL
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Zip | 33325-2815
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Country | US
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Telephone | 605-690-8580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA M SANFORD
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Credential |
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Telephone | 605-690-8580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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