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General NPI Number Information
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NPI Number | 1891933792
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Entity Type | Individual
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Provider Name | MICHELLE M SANBORN MD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2009
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 86 W UNDERWOOD ST
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City | ORLANDO
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State | FL
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Zip | 32806-1110
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Country | US
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Telephone | 888-912-3648
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Fax | 321-841-4085
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Provider Business Mailing Address
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Address Line | 11212 NE TIGER WAY
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City | KINGSTON
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State | WA
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Zip | 98346-4515
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Country | US
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Telephone | 321-274-7448
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2020005839
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME142714
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 73908
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 61109513
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License Number State | WA
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