MEDICARE: S & S PODIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760002596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S & S PODIATRY LLC

Provider Business Mailing Address
First Line	:	16400 NE 19TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4115
Country	:	US
Telephone Number	:	305-772-9058
Fax Number	:

Provider Business Practice Location Address
First Line	:	3595 W 20TH AVE STE 125
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4537
Country	:	US
Telephone Number	:	305-864-1373
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DMITRY SANDLER
Credential	:	DPM
Telephone Number	:	305-772-9058

Provider Enumeration Date	:	04/22/2020
Last Update Date	:	02/16/2023

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Directions to “S & S PODIATRY LLC ” Practice Location

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