Provider Demographics
NPI:1205195534
Name:SOUTH FLORIDA PHYSICIAN CARE NETWORK P.A.
Entity Type:Organization
Organization Name:SOUTH FLORIDA PHYSICIAN CARE NETWORK P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSWALDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-631-6840
Mailing Address - Street 1:1275 W 47TH PL
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3394
Mailing Address - Country:US
Mailing Address - Phone:305-631-6840
Mailing Address - Fax:305-631-6894
Practice Address - Street 1:1275 W 47TH PL
Practice Address - Street 2:SUITE 307
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3394
Practice Address - Country:US
Practice Address - Phone:305-631-6840
Practice Address - Fax:305-631-6894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty