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 1:10383 HAGEN RANCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3782
Mailing Address - Country:US
Mailing Address - Phone:561-739-5252
Mailing Address - Fax:561-739-5255
Practice Address - Street 1:3431 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3981
Practice Address - Country:US
Practice Address - Phone:786-527-2693
Practice Address - Fax:786-527-2692
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18712207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology