Provider Demographics
NPI:1790071603
Name:SANDHU-RESTAINO, SANDRA KAUR (DO)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAUR
Last Name:SANDHU-RESTAINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR STE 7300
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3416
Mailing Address - Country:US
Mailing Address - Phone:561-935-1352
Mailing Address - Fax:561-935-1358
Practice Address - Street 1:1411 N FLAGLER DR STE 7300
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3416
Practice Address - Country:US
Practice Address - Phone:561-935-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12890208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS12890OtherMEDICAL LICENSE