Healthcare Provider Details

I. General information

NPI: 1942073309
Provider Name (Legal Business Name): SABRINA MIA LEZOTTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

IV. Provider business mailing address

10540 SKY FLOWER CT
LAND O LAKES FL
34638-6943
US

V. Phone/Fax

Practice location:
  • Phone: 480-712-8319
  • Fax:
Mailing address:
  • Phone: 954-415-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: