Individual
SANDY BEN KAMANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9974 TIMBER FALLS LN, JACKSONVILLE, FL 32219-4357
(904) 400-4033
Mailing address
9974 TIMBER FALLS LN, JACKSONVILLE, FL 32219-4357
(904) 400-4033
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-2883266
IRS
—
Enumeration date
03/12/2020
Last updated
03/12/2020
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