Physician Compare National (NPI:1093716771)

HEALTHCARE PROVIDER: EDGAR SANDOVAL M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093716771
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244375129
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100303000366
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SANDOVAL
	Individual professional last name
Provider First Name	EDGAR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	20900 BISCAYNE BLVD
	Group Practice or individual's line 1 address
City	AVENTURA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	331801407
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3056827000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100034
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MOUNT SINAI MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100131
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	AVENTURA HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y