Provider Demographics
NPI:1366806770
Name:SABOYA, RENEE MARY (ARNP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:MARY
Last Name:SABOYA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 21ST AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7847
Mailing Address - Country:US
Mailing Address - Phone:941-761-4448
Mailing Address - Fax:941-761-0235
Practice Address - Street 1:6001 21ST AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7847
Practice Address - Country:US
Practice Address - Phone:941-761-4448
Practice Address - Fax:941-761-0235
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9277493363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care