Provider Demographics
NPI:1053657585
Name:SANABRIA, ANTOINETTE SUZETTE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:SUZETTE
Last Name:SANABRIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 LEE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4846
Mailing Address - Country:US
Mailing Address - Phone:239-369-2163
Mailing Address - Fax:239-368-7497
Practice Address - Street 1:1350 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4846
Practice Address - Country:US
Practice Address - Phone:239-369-2163
Practice Address - Fax:239-368-7497
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 31461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist