Provider Demographics
NPI:1104880533
Name:SANDLER, RAYMOND B (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:B
Last Name:SANDLER
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 1:100 NW 170TH ST
Mailing Address - Street 2:SUITE # 410
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5513
Mailing Address - Country:US
Mailing Address - Phone:305-654-6850
Mailing Address - Fax:305-654-6858
Practice Address - Street 1:100 NW 170TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5513
Practice Address - Country:US
Practice Address - Phone:305-654-6850
Practice Address - Fax:305-654-6858
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075598207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270181200Medicaid
FL48072ZMedicare ID - Type Unspecified
FL270181200Medicaid