Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sandro Theodore, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1346959798

Sandro Theodore, PHYSICIANASSISTANT is a Physician Assistant in Riverview, Florida. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

11552 Brighton Knoll Loop
Riverview, FL 33579-2123
Phone: (941) 592-9294
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1346959798
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedNovember 15, 2022
Last updated in NPPESNovember 15, 2022
Certification dateNovember 15, 2022
Mailing address11552 Brighton Knoll Loop, Riverview, FL 33579-2123

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