Provider Demographics
NPI:1336466770
Name:SABO, NATALIE (COTA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:SABO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7997 PALACIO DEL MAR DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4149
Mailing Address - Country:US
Mailing Address - Phone:561-368-2685
Mailing Address - Fax:
Practice Address - Street 1:7997 PALACIO DEL MAR DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4149
Practice Address - Country:US
Practice Address - Phone:561-368-2685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11242171W00000X
NY007417-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor