Provider Demographics
NPI:1518542216
Name:PHILLIPS, SABRINA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:PHILLIPS
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 1:9205 RAMBLEWOOD DR APT 822
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7076
Mailing Address - Country:US
Mailing Address - Phone:954-882-3702
Mailing Address - Fax:
Practice Address - Street 1:9205 RAMBLEWOOD DR APT 822
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7076
Practice Address - Country:US
Practice Address - Phone:954-882-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP412792808810Medicaid