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General NPI Number Information
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NPI Number | 1891409686
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Entity Type | Organization
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Legal Business Name | S D HEALTHCARE INC
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Dates
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Enumeration Date | 01/06/2023
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 5400 S UNIVERSITY DR STE 301
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City | DAVIE
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State | FL
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Zip | 33328-5310
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Country | US
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Telephone | 954-636-2332
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Fax | 240-219-3195
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Provider Business Mailing Address
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Address Line | 5400 S UNIVERSITY DR STE 301
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City | DAVIE
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State | FL
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Zip | 33328-5310
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Country | US
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Telephone | 954-647-5609
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Fax |
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Authorized Official
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Title or Position | NP
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Name | SANDRA S DACCARETT
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Credential | DNP
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Telephone | 954-647-5609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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