Provider Demographics
NPI:1376032011
Name:SANABRIA, MICHEL
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4599 NW 9TH ST APT 58
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2316
Mailing Address - Country:US
Mailing Address - Phone:786-484-5912
Mailing Address - Fax:
Practice Address - Street 1:2911 SW 16TH TER # A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1957
Practice Address - Country:US
Practice Address - Phone:786-484-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLAPRN11023493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician