Provider Demographics
NPI:1104329242
Name:ISKANDAR, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ISKANDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8903 GLADES RD STE K1A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4010
Mailing Address - Country:US
Mailing Address - Phone:561-955-6115
Mailing Address - Fax:833-625-1622
Practice Address - Street 1:8903 GLADES RD STE K1A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4010
Practice Address - Country:US
Practice Address - Phone:561-955-6115
Practice Address - Fax:833-625-1622
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17998207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program