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General NPI Number Information
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NPI Number | 1366109688
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Entity Type | Individual
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Provider Name | MS. MARY SABILLENA
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Gender | Female
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 7104 BOX ELDER DR
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City | PORT RICHEY
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State | FL
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Zip | 34668-6906
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Country | US
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Telephone | 727-232-6484
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Fax | 813-252-1401
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Provider Business Mailing Address
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Address Line | 7104 BOX ELDER DR
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City | PORT RICHEY
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State | FL
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Zip | 34668-6906
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Country | US
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Telephone | 727-232-6484
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Fax | 813-252-1401
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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 | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6907055
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License Number State | FL
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