Individual
SANDY ALIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4400 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5862
(954) 486-8020
(954) 486-8983
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(954) 486-8020
(954) 486-8983
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11002181
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104659500
—
FL
Enumeration date
06/25/2019
Last updated
12/23/2019
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