Provider Demographics
NPI:1528229002
Name:SANDKOVSKY, GABRIEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:G
Last Name:SANDKOVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N MILITARY TRL STE 243
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6362
Mailing Address - Country:US
Mailing Address - Phone:561-496-1095
Mailing Address - Fax:561-948-4473
Practice Address - Street 1:2900 N MILITARY TRL STE 243
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6362
Practice Address - Country:US
Practice Address - Phone:561-496-1095
Practice Address - Fax:561-948-4473
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003091207RI0200X
FLME112712207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00656238Medicare PIN
FLGH124ZMedicare PIN