Provider Demographics
NPI:1588753040
Name:SANDLER, DMITRY (DPM, FACFAS)
Entity type:Individual
Prefix:MR
First Name:DMITRY
Middle Name:
Last Name:SANDLER
Suffix:
Gender:M
Credentials:DPM, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR
Mailing Address - Street 2:STE. 280
Mailing Address - City:N. MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4758
Mailing Address - Country:US
Mailing Address - Phone:305-735-2022
Mailing Address - Fax:305-749-6505
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:STE. 280
Practice Address - City:N. MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4758
Practice Address - Country:US
Practice Address - Phone:305-735-2022
Practice Address - Fax:305-749-6505
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2931213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270007700Medicaid
FL119104700Medicaid
FLU92045Medicare UPIN
FL270007700Medicaid