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General NPI Number Information
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NPI Number | 1861634065
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Entity Type | Organization
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Legal Business Name | SANDRA R. GOTMAN, D.P.M., P.A.
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 07/04/2010
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Provider Practice Location Address
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Address Line | 11760 SW 40TH ST SUITE 616
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City | MIAMI
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State | FL
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Zip | 33175-8100
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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 | 11760 SW 40TH ST SUITE 616
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City | MIAMI
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State | FL
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Zip | 33175-8100
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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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Authorized Official
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Title or Position | PRESIDENT/ DOCTOR
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Name | SANDRA R GOTMAN
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Credential | D.P.M.
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Telephone | 305-229-9596
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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 | PO 1678
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License Number State | FL
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