Provider Demographics
NPI:1962436220
Name:ALTMAN, SANFORD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:DAVID
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16401 NW 2ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6036
Mailing Address - Country:US
Mailing Address - Phone:305-948-5333
Mailing Address - Fax:305-948-3246
Practice Address - Street 1:16401 NW 2ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6036
Practice Address - Country:US
Practice Address - Phone:305-948-5333
Practice Address - Fax:305-948-3246
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME584952085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL219509OtherAVMED PIN
FL18527OtherBCBS OF FL PIN
FL219509OtherAVMED PIN
FLF48762Medicare UPIN