Provider Demographics
NPI:1962473017
Name:SANDROW, RICHARD EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWARD
Last Name:SANDROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 SW 88TH ST STE 1003E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2178
Mailing Address - Country:US
Mailing Address - Phone:305-595-2550
Mailing Address - Fax:305-595-2555
Practice Address - Street 1:8940 SW 88TH ST STE 1003E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2178
Practice Address - Country:US
Practice Address - Phone:305-595-2550
Practice Address - Fax:305-595-2555
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0016459207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1215298OtherCIGNA ID NUMBER
200028760OtherRAILROAD MEDICARE ID
FL000988OtherNEIGHBORHOOD HEALTH INS
FL10720068OtherCAQH PROVIDER ID
FL206537OtherAVMED ID NUMBER
374544200OtherUS DEPT OF LABOR ID NUMBE
FL91255OtherBCBS ID NUMBER
FL852998OtherAETNA ID NUMBER
FL91255OtherBCBS ID NUMBER
FL1215298OtherCIGNA ID NUMBER
FL0902180OtherUNITED ID NUMBER