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General NPI Number Information
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NPI Number | 1861435760
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Entity Type | Individual
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Provider Name | OSWALDO S SANDOVAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 7630 SW 34TH MNR STE 440
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City | DAVIE
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State | FL
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Zip | 33328-1986
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Country | US
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Telephone | 954-866-8615
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Fax |
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Provider Business Mailing Address
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Address Line | 7050 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-3804
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Country | US
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Telephone | 954-399-9014
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Fax | 954-367-7175
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME65506
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License Number State | FL
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