Individual
DR. MICHAEL JOSEPH DISANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3885
Mailing address
3200 SW 60TH CT, SUITE 105, MIAMI, FL 33155-4000
(305) 669-6448
(305) 663-8485
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
83628
FL
2088P0231X
Pediatric Urology Physician
Primary
G70600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263295100
—
FL
Enumeration date
06/23/2006
Last updated
08/04/2023
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