Provider Demographics
NPI:1023093010
Name:SANDLER, MICHAEL ELLIOT (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ELLIOT
Last Name:SANDLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GEORGE BUSH BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-4034
Mailing Address - Country:US
Mailing Address - Phone:561-276-2800
Mailing Address - Fax:561-286-7079
Practice Address - Street 1:217 GEORGE BUSH BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-4034
Practice Address - Country:US
Practice Address - Phone:561-276-2800
Practice Address - Fax:561-286-7079
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 0001442152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL085922200Medicaid
FL085922200Medicaid
FL0568440001Medicare NSC