Provider Demographics
NPI:1891409686
Name:S D HEALTHCARE INC
Entity Type:Organization
Organization Name:S D HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DACCARETT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:954-647-5609
Mailing Address - Street 1:5400 S UNIVERSITY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5310
Mailing Address - Country:US
Mailing Address - Phone:954-647-5609
Mailing Address - Fax:
Practice Address - Street 1:5400 S UNIVERSITY DR STE 301
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5310
Practice Address - Country:US
Practice Address - Phone:954-647-5609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty