Active NPI
Jose A Sandoval, PH.D.
- Psychologist
- Miami, FL
National Provider Identifier
1568640548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY7539
- Practice address
- 11401 SW 40TH St
Suite 321
Miami, FL 33165-3372 - Phone
- (305) 720-0237
- NPI assigned
- Feb 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY7539 | FL | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | PY7539 | FL | |
| Clinical Psychologist | 103TC0700X | PY7539 | FL |
Addresses
Primary practice location
11401 SW 40TH St
Suite 321
Miami, FL 33165-3372
Mailing address
11401 SW 40TH St
Suite# 321
Miami, FL 33165-3372
Phone (305) 720-0237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY7539 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300406400000",
"number": "1568640548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11401 SW 40TH ST",
"address_2": "SUITE# 321",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653372",
"telephone_number": "305-720-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11401 SW 40TH ST",
"address_2": "SUITE 321",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653372",
"telephone_number": "305-720-0237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "JOSE",
"middle_name": "A",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-01",
"last_updated": "2011-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY7539",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "FL",
"license": "PY7539",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY7539",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.