Provider Demographics
NPI:1043453616
Name:DELEON MANSSON, SARAH JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JANE
Last Name:DELEON MANSSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8340 COLLIER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3589
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:239-348-4337
Practice Address - Street 1:8340 COLLIER BLVD STE 305
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:239-348-4337
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08553100207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0201669Medicaid
NJ160870ZD3TMedicare PIN