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General NPI Number Information
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NPI Number | 1669133690
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Entity Type | Individual
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Provider Name | BIANCA SARUBBI
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Gender | Female
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 12950 RACE TRACK RD STE 106
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City | TAMPA
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State | FL
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Zip | 33626-1304
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Country | US
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Telephone | 813-616-8810
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 BERRYKNOLL PL
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City | VALRICO
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State | FL
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Zip | 33596-5730
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Country | US
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Telephone | 813-453-1752
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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