Provider Demographics
NPI:1013111491
Name:SANDMAN, YEKUTIEL (MD)
Entity Type:Individual
Prefix:
First Name:YEKUTIEL
Middle Name:
Last Name:SANDMAN
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 1:7600 SW 87TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3601
Mailing Address - Country:US
Mailing Address - Phone:305-275-5525
Mailing Address - Fax:305-275-0662
Practice Address - Street 1:7600 SW 87TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3601
Practice Address - Country:US
Practice Address - Phone:305-275-5525
Practice Address - Fax:305-275-0662
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98722208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03671OtherBCBS
FL7600965OtherAETNA
FL278579000Medicaid
FL59173OtherNHP
FL400006973000OtherPREFERRED CARE PARTNERS
FL11772371OtherCOVENTRY FIRST HEALTH
FL11683OtherDIMENSION HEALTH
FL7600965OtherAETNA