Provider Demographics
NPI:1871066571
Name:DSOUZA, SANDRA E (DO)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8727 TEMPLE TERRACE HWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-6700
Mailing Address - Country:US
Mailing Address - Phone:813-796-5400
Mailing Address - Fax:813-776-0079
Practice Address - Street 1:8727 TEMPLE TERRACE HWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-6700
Practice Address - Country:US
Practice Address - Phone:813-796-5400
Practice Address - Fax:813-776-0079
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine