Provider Demographics
NPI:1528092301
Name:SABRA, ROBIN J (PA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:SABRA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 SW 64TH ST
Mailing Address - Street 2:DERMATOLOGY
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9608
Mailing Address - Country:US
Mailing Address - Phone:352-376-1611
Mailing Address - Fax:352-379-4082
Practice Address - Street 1:5571 SW 64TH ST
Practice Address - Street 2:DERMATOLOGY
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9608
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:352-379-4082
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000822085R0202X
MAPA400363AM0700X
FL9103447363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology