Provider Demographics
NPI:1215423439
Name:SNEDAKER, SABRINA I
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:I
Last Name:SNEDAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 ELKCAM BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2626
Mailing Address - Country:US
Mailing Address - Phone:386-532-8200
Mailing Address - Fax:386-774-6862
Practice Address - Street 1:734 ELKCAM BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-2626
Practice Address - Country:US
Practice Address - Phone:386-532-8200
Practice Address - Fax:386-774-6862
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9337094163WG0000X
FLARNP9337094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice