Provider Demographics
NPI:1215375522
Name:SOBEL, IRINA PETROVNA
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:PETROVNA
Last Name:SOBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MAINSAIL CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-1407
Mailing Address - Country:US
Mailing Address - Phone:203-554-8302
Mailing Address - Fax:
Practice Address - Street 1:7111 FAIRWAY DR
Practice Address - Street 2:SUITE 450
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-4204
Practice Address - Country:US
Practice Address - Phone:561-799-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-08
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9287949367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered