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General NPI Number Information
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NPI Number | 1508851692
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Entity Type | Individual
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Provider Name | SANDRA RACHEL GOTMAN D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 11760 SW 40TH ST STE 448
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City | MIAMI
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State | FL
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Zip | 33175-3598
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Country | US
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Telephone | 305-229-9595
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Fax | 305-229-9596
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Provider Business Mailing Address
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Address Line | 8200 NW 27TH ST STE 108
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City | DORAL
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State | FL
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Zip | 33122-1902
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Country | US
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Telephone | 786-662-3893
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Fax | 786-662-3899
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P0-1678
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License Number State | FL
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