Provider Demographics
NPI:1578561601
Name:HARRY SENDZISCHEW MD PA
Entity Type:Organization
Organization Name:HARRY SENDZISCHEW MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SENDZISCHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-868-5323
Mailing Address - Street 1:1029 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2105
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 HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2105
Practice Address - Country:US
Practice Address - Phone:305-868-5323
Practice Address - Fax:305-866-9178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34770208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267829200Medicaid
FL267829200Medicaid