Provider Information for 1568640548
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JOSE A SANDOVAL Ph.D.
Sex: Male
NPI: 1568640548
Last Updated: 2011-03-18
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1568640548 | ||||||||||||||||
| Enumeration Date | 2008-02-01 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 11401 SW 40TH ST SUITE# 321 MIAMI, FL 33165-3372 United States Phone: 305-720-0237 | Fax: | ||||||||||||||||
| Primary Practice Address | 11401 SW 40TH ST SUITE 321 MIAMI, FL 33165-3372 United States Phone: 305-720-0237 | Fax: | ||||||||||||||||
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