Provider Demographics
NPI:1265022511
Name:MITSON, SABRINA N
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:N
Last Name:MITSON
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 1:4221 NW 53RD CT
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4006
Mailing Address - Country:US
Mailing Address - Phone:954-864-5025
Mailing Address - Fax:
Practice Address - Street 1:4221 NW 53RD CT
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4006
Practice Address - Country:US
Practice Address - Phone:954-864-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program