Provider Demographics
NPI:1336147362
Name:PLEVIN, SANFORD NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:NORMAN
Last Name:PLEVIN
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 1:3890 TAMPA RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3676
Mailing Address - Country:US
Mailing Address - Phone:727-784-2424
Mailing Address - Fax:727-784-4723
Practice Address - Street 1:3890 TAMPA RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3676
Practice Address - Country:US
Practice Address - Phone:727-784-2424
Practice Address - Fax:727-784-4723
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16355207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56224Medicare UPIN
FL52726YMedicare ID - Type Unspecified