Provider Demographics
NPI:1528202546
Name:MOLOCZNIK, SANDRA EUGENIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:EUGENIA
Last Name:MOLOCZNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3363 NE 163RD ST
Mailing Address - Street 2:SUITE 809
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4401
Mailing Address - Country:US
Mailing Address - Phone:786-345-1516
Mailing Address - Fax:786-513-2617
Practice Address - Street 1:3363 NE 163RD ST
Practice Address - Street 2:SUITE 809
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4401
Practice Address - Country:US
Practice Address - Phone:786-345-1516
Practice Address - Fax:786-513-2617
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 103726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine