Healthcare Provider Details

I. General information

NPI: 1669195772
Provider Name (Legal Business Name): SABRINA TREVINO URRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18920 NW 63RD COURT CIR
HIALEAH FL
33015-4723
US

IV. Provider business mailing address

18920 NW 63RD COURT CIR
HIALEAH FL
33015-4723
US

V. Phone/Fax

Practice location:
  • Phone: 305-240-7763
  • Fax:
Mailing address:
  • Phone: 305-240-7763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90130
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: