Provider Demographics
NPI:1376225797
Name:SANDS, SIDNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3058 RIBBON GRASS DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7873
Mailing Address - Country:US
Mailing Address - Phone:321-223-8584
Mailing Address - Fax:
Practice Address - Street 1:850 CENTURY MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2141
Practice Address - Country:US
Practice Address - Phone:321-567-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor