Provider Demographics
NPI:1861441347
Name:CHERTOCK, SANFORD L (PHD)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:L
Last Name:CHERTOCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20161 UMBRIA HILL DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1932
Mailing Address - Country:US
Mailing Address - Phone:513-673-9379
Mailing Address - Fax:
Practice Address - Street 1:20161 UMBRIA HILL DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1932
Practice Address - Country:US
Practice Address - Phone:513-673-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11328103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical