Provider Demographics
NPI:1437116480
Name:LEGORBURU-SELEM, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:LEGORBURU-SELEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 GRANELLO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1806
Mailing Address - Country:US
Mailing Address - Phone:305-446-2546
Mailing Address - Fax:305-448-0219
Practice Address - Street 1:305 GRANELLO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1806
Practice Address - Country:US
Practice Address - Phone:305-446-2546
Practice Address - Fax:305-448-0219
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL039341208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics