Healthcare Provider Details

I. General information

NPI: 1265116172
Provider Name (Legal Business Name): SABRINA LISBETH MORETA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E ROLLINS ST STE 11100
ORLANDO FL
32804-5570
US

IV. Provider business mailing address

265 E ROLLINS ST STE 11100
ORLANDO FL
32804-5570
US

V. Phone/Fax

Practice location:
  • Phone: 844-407-4070
  • Fax: 407-743-3050
Mailing address:
  • Phone: 844-407-4070
  • Fax: 407-743-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: