Healthcare Provider Details

I. General information

NPI: 1073189577
Provider Name (Legal Business Name): DINAH SANON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12280 LAKE UNDERHILL RD
ORLANDO FL
32825-5009
US

IV. Provider business mailing address

300 NE 151ST ST
MIAMI FL
33162-5012
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 305-834-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03200579
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2376303
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: