Provider Demographics
NPI:1346085867
Name:SOBRERO, STEFANIA (DC)
Entity type:Individual
Prefix:
First Name:STEFANIA
Middle Name:
Last Name:SOBRERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20976 UPTOWN AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6576
Mailing Address - Country:US
Mailing Address - Phone:516-225-2973
Mailing Address - Fax:
Practice Address - Street 1:11360 LEGACY AVE UNIT 110
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3663
Practice Address - Country:US
Practice Address - Phone:561-295-7778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor