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General NPI Number Information
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NPI Number | 1013472042
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Entity Type | Individual
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Provider Name | CHRISTINE ANNE SACRAMENTO ATC, NREMT-B
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Gender | Female
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 20803 JOHNSON ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1916
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Country | US
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Telephone | 954-442-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 16736 DIAMOND DR
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City | WESTON
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State | FL
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Zip | 33331-3160
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Country | US
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Telephone | 954-261-7042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | EMT543674
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL4122
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License Number State | FL
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