Provider Demographics
NPI:1558426049
Name:SENDZISCHEW, HARRY (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:SENDZISCHEW
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 1:1029 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOUR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154
Mailing Address - Country:US
Mailing Address - Phone:305-868-5323
Mailing Address - Fax:305-866-9178
Practice Address - Street 1:1029 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOUR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154
Practice Address - Country:US
Practice Address - Phone:305-868-5323
Practice Address - Fax:305-866-9178
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0034770208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63486Medicare UPIN
FL95494ZMedicare PIN