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General NPI Number Information
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NPI Number | 1902302748
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Entity Type | Organization
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Legal Business Name | SANDHILL PEDIATRICS, P.A.
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 21758 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33549-6921
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Country | US
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Telephone | 813-563-6070
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Fax | 813-563-6040
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Provider Business Mailing Address
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Address Line | 21758 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33549-6921
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Country | US
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Telephone | 813-563-6070
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Fax | 813-563-6040
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Authorized Official
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Title or Position | PHYSICIAN
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Name | WENDY J MASTERMAN
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Credential | MD
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Telephone | 813-563-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | FL
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