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General NPI Number Information
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NPI Number | 1053428383
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Entity Type | Individual
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Provider Name | SANDRA Y MITJANS MD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 4305 E 8TH AVE STE E
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City | HIALEAH
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State | FL
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Zip | 33013
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Country | US
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Telephone | 305-769-5601
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Fax | 305-769-0473
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Provider Business Mailing Address
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Address Line | 2843 SW 174TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33029-5549
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Country | US
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Telephone | 305-769-5601
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Fax | 305-769-0473
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | ME40785
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License Number State | FL
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