Provider Demographics
NPI:1265022511
Name:MITSON, SABRINA N
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:N
Last Name:MITSON
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 1:5659 VIA DE LA PLATA CIR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6442
Mailing Address - Country:US
Mailing Address - Phone:954-864-5025
Mailing Address - Fax:
Practice Address - Street 1:5901 SW 74TH ST STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5163
Practice Address - Country:US
Practice Address - Phone:305-390-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9118540363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant