Provider Demographics
NPI:1659698900
Name:SARDINAS, ODALYS (MA)
Entity Type:Individual
Prefix:
First Name:ODALYS
Middle Name:
Last Name:SARDINAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 SW 86TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4028
Mailing Address - Country:US
Mailing Address - Phone:305-262-3368
Mailing Address - Fax:305-262-3369
Practice Address - Street 1:895 SW 86TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4028
Practice Address - Country:US
Practice Address - Phone:305-262-3368
Practice Address - Fax:305-262-3369
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist