Provider Demographics
NPI:1437670536
Name:MIZELL, SABRINA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:MIZELL
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:PO BOX 940924
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-0924
Mailing Address - Country:US
Mailing Address - Phone:407-529-7811
Mailing Address - Fax:
Practice Address - Street 1:1323 EDISON TREE RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6455
Practice Address - Country:US
Practice Address - Phone:407-529-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management