DR. SANDEE JEWEL BRISTOW (NPI# 1629263694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629263694 |
| Entity Type | Individual |
| Full Name | DR. SANDEE JEWEL BRISTOW |
| Credential | MD |
| Practice Address |
21000 Ne 28th Ave Ste 104 Aventura FL 33180-1421 |
| Mailing Address |
Po Box 223190 Hollywood FL 33022-3190 |
| Practice Telephone | 3059745533 |
| Practice Fax Number | 3059745553 |
| Mailing Telephone | 3059745533 |
| Mailing Fax Number | 3059745553 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2019-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
104374 | FL | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
MD60152790 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1629263694 | 05 | |
| WA | MEDICAL LICENSE | MD60152790 | 01 |
| FL | MEDICAL LICENSE | ME104374 | 01 |
| WA | L&I | 0280818 | 01 |
| Street Address |
21000 NE 28TH AVE STE 104 |
| City | AVENTURA |
| State | FL |
| Zip Code | 33180-1421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912987983 | Christian David Gonzalez | Anesthesiology | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2006-01-18 |
| 1942809959 | Stephanie Amortegui | Physician Assistant | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2020-10-21 |
| 1508406224 | Kareen Gail Phillipa Jones | Nurse Practitioner | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2020-01-10 |
| 1780222398 | Golden Physical Therapy Inc | Physical Therapist | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2019-12-13 |
| 1366916975 | Usa Sports Therapy Florida Inc | Physical Therapist | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2019-01-16 |
| 1164820692 | Florida Chiropractic & Sports, Inc | Chiropractor | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180 | 2014-12-16 |
| 1972945061 | Jeffrey Cara | Pain Medicine | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2013-07-18 |
| 1568809325 | Christian Gonzalez, Md, LLC | Internal Medicine | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2013-06-03 |
| 1972875227 | Raina Simone Hachet | Physician Assistant | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2012-02-02 |
| 1730479387 | Eduardo Jose Jusino | Anesthesiology | 21000 Ne 28th Ave Ste 104, Aventura, FL 33180-1421 | 2011-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607849 | Nabeel Rahman Khan | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Boulevard, Avetura, Fl, Aventura, FL 33180 | 2020-04-09 |
| 1235766841 | Hanny Hausmann | Counselor | 2999 Ne 191 Street, Suite 902, Aventura, FL 33180 | 2020-03-24 |
| 1760976369 | Michael Ernest Molino | Optometrist | 19575 Biscayne Blvd Ste 579, Aventura, FL 33180 | 2018-06-18 |
| 1932602620 | Carmen Somarriba | Physician Assistant | 21110 Biscayne Blvd Bldg Suite400, Aventura, FL 33180 | 2018-03-09 |
| 1235631474 | Premier Florida Podiatry, Pa | Podiatrist | 3060 Ne 190th St Apt 202, Aventura, FL 33180 | 2018-03-04 |
| 1891229126 | Ifrah Zahid Butt | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd., Aventura, FL 33180 | 2017-04-13 |
| 1629500129 | Hector Hugo Gonzalez | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd, South Tower, #807, Aventura Hospital and Medical Center, Aventura, FL 33180 | 2017-04-03 |
| 1457892671 | Nusen Beer | Internal Medicine | 20200 W Dixie Hwy Ste 701, Aventura, FL 33180 | 2017-03-20 |
| 1073052338 | Alfa Diagnostic LLC | Point of Service | 21355 E Dixie Hwy Ste 101, Aventura, FL 33180 | 2017-02-20 |
| 1598211740 | Katherine Mendez-martinez | Nurse Practitioner | 2925 Aventura Blvd. Suite 101, Aventura, FL 33180 | 2016-08-28 |
| Find all providers in zip 33180 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161214 | Radius Medical Center LLC | Physical Medicine & Rehabilitation | 2425 E Commercial Blvd Ste 203, Fort Lauderdale, FL 33308-4062 | 2020-07-17 |
| 1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
| 1508320342 | Grigory Pogrebinsky Md Pa | Physical Medicine & Rehabilitation | 12450 Tamiami Trl S Unit E, North Port, FL 34287-1473 | 2019-01-25 |
| 1235611815 | Peter Danger Molina | Physical Medicine & Rehabilitation | 1190 Nw 95th St Ste 200, Miami, FL 33150-2064 | 2018-08-30 |
| 1497246540 | Restore Medical Partners Pllc | Physical Medicine & Rehabilitation | 333 Tamiami Trl S Ste 101, Venice, FL 34285-2425 | 2018-05-24 |
| 1568952240 | South Florida Physical Medicine and Rehabilitation Center LLC | Physical Medicine & Rehabilitation | 1200 S Main St Ste 200, Belle Glade, FL 33430-7808 | 2018-05-17 |
| 1235641655 | Boca Pain Care, Inc | Physical Medicine & Rehabilitation | 851 Meadows Rd Ste 213, Boca Raton, FL 33486-2348 | 2017-10-25 |
| 1558870477 | Pain Control Solutions II LLC | Physical Medicine & Rehabilitation | 8323 Nw 12th Street, Suite 115, Miami, FL 33126 | 2017-09-22 |
| 1245759851 | Chelsea Hakeem | Physical Medicine & Rehabilitation | 8936 77th Terrace East, Suit 101, Lakewood Ranch, FL 34202 | 2017-09-14 |
| 1508384165 | Destiny Therapy Center Inc | Physical Medicine & Rehabilitation | 7480 Fairway Dr., Suite 101, Miami Lakes, FL 33014 | 2017-09-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.