Healthcare Provider Details

I. General information

NPI: 1609386887
Provider Name (Legal Business Name): JANETH PAOLA SAWH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANETH PAOLA PENA

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 W OAKLAND PARK BLVD STE 100
SUNRISE FL
33351-7223
US

IV. Provider business mailing address

8890 W OAKLAND PARK BLVD STE 100
SUNRISE FL
33351-7223
US

V. Phone/Fax

Practice location:
  • Phone: 954-741-3304
  • Fax:
Mailing address:
  • Phone: 954-741-3304
  • Fax: 754-222-6417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110731
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: