Provider Demographics
NPI:1972237626
Name:SANON, TRUCHA (NP)
Entity Type:Individual
Prefix:
First Name:TRUCHA
Middle Name:
Last Name:SANON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:SANON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4800 N NOB HILL RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4799
Mailing Address - Country:US
Mailing Address - Phone:954-577-3600
Mailing Address - Fax:
Practice Address - Street 1:4800 N NOB HILL RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-4799
Practice Address - Country:US
Practice Address - Phone:954-577-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-10
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2022015016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily