Provider Demographics
NPI:1851677066
Name:BALSANO, SARAH NICOLE (PT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:NICOLE
Last Name:BALSANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 NW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-1510
Mailing Address - Country:US
Mailing Address - Phone:386-846-8070
Mailing Address - Fax:
Practice Address - Street 1:1905 CLINT MOORE RD STE 102
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2659
Practice Address - Country:US
Practice Address - Phone:561-994-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist