MEDICARE: MISS JESSICA SANABRIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	46TR00523500	NJ

General Provider Information

NPI Number	:	1568616621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JESSICA SANABRIA

Provider Business Mailing Address
First Line	:	3704 NW 213TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1159
Country	:	US
Telephone Number	:	786-390-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	3704 NW 213TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1159
Country	:	US
Telephone Number	:	786-390-5488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2008
Last Update Date	:	12/01/2010

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Directions to “ MISS JESSICA SANABRIA ” Practice Location

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