Provider Demographics
NPI:1821616558
Name:SANDS, DOMINIC
Entity Type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:
Last Name:SANDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BILTMORE WAY APT 807
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7538
Mailing Address - Country:US
Mailing Address - Phone:561-430-7631
Mailing Address - Fax:
Practice Address - Street 1:625 BILTMORE WAY APT 807
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7538
Practice Address - Country:US
Practice Address - Phone:561-430-7631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies