Healthcare Provider Details

I. General information

NPI: 1255518353
Provider Name (Legal Business Name): ABIMAEL SANABIA BC-HIS, ACA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W COLONIAL DR STE 101
ORLANDO FL
32804-7356
US

IV. Provider business mailing address

710 W COLONIAL DR STE 101
ORLANDO FL
32804-7356
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-9696
  • Fax:
Mailing address:
  • Phone: 407-649-9696
  • Fax: 407-649-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS2556
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: