Provider Demographics
NPI:1154320166
Name:LAMPHIER, SANDRA W (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:W
Last Name:LAMPHIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:W
Other - Last Name:LAMPHIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12470 TELECOM DR STE 300W
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16524 JESSAMINE RD
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33523-7432
Practice Address - Country:US
Practice Address - Phone:352-588-2165
Practice Address - Fax:352-588-4628
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56268207QH0002X
FL0056268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0357863000Medicaid
FL092312Medicare ID - Type Unspecified
FLC68819Medicare UPIN