Provider Demographics
NPI:1508153313
Name:ITENBERG, SARIT J (DO)
Entity Type:Individual
Prefix:
First Name:SARIT
Middle Name:J
Last Name:ITENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9528 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2502
Mailing Address - Country:US
Mailing Address - Phone:603-571-2415
Mailing Address - Fax:786-401-3721
Practice Address - Street 1:9528 HARDING AVE
Practice Address - Street 2:
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-2502
Practice Address - Country:US
Practice Address - Phone:603-571-2415
Practice Address - Fax:786-401-3721
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18712207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology