Provider Demographics
NPI:1386695880
Name:SANDHU, JASWINDER SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:JASWINDER
Middle Name:SINGH
Last Name:SANDHU
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 1:110 WASHINGTON AVE
Mailing Address - Street 2:#1305
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-7221
Mailing Address - Country:US
Mailing Address - Phone:305-535-8069
Mailing Address - Fax:
Practice Address - Street 1:1400 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1003
Practice Address - Country:US
Practice Address - Phone:305-547-6468
Practice Address - Fax:305-547-6469
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0093799207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274497000Medicaid
FLU6856ZMedicare PIN
FLI49244Medicare UPIN
FLU6856AMedicare ID - Type Unspecified