Provider Demographics
NPI:1306363304
Name:BRUNO, SABRINA ANN (COTA/L)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:ANN
Last Name:BRUNO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18349 104TH TER S
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-1650
Mailing Address - Country:US
Mailing Address - Phone:561-305-2480
Mailing Address - Fax:
Practice Address - Street 1:3215 NW 10TH TER STE 211
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5938
Practice Address - Country:US
Practice Address - Phone:954-537-7949
Practice Address - Fax:866-210-0998
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16071224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant