Provider Demographics
NPI:1093900300
Name:DR SANFORD PLEVIN MD PL
Entity Type:Organization
Organization Name:DR SANFORD PLEVIN MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:N
Authorized Official - Last Name:PLEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-784-2424
Mailing Address - Street 1:3890 TAMPA RD
Mailing Address - Street 2:STE 301
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684
Mailing Address - Country:US
Mailing Address - Phone:727-784-2424
Mailing Address - Fax:727-784-4723
Practice Address - Street 1:3890 TAMPA RD
Practice Address - Street 2:STE 301
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684
Practice Address - Country:US
Practice Address - Phone:727-784-2424
Practice Address - Fax:727-784-4723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0016355207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty