Provider Demographics
NPI:1992469027
Name:SANABRIA, NIC (MS, MT-BC, NRMT)
Entity type:Individual
Prefix:
First Name:NIC
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:M
Credentials:MS, MT-BC, NRMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 BROADSTONE WAY APT 104
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1645
Mailing Address - Country:US
Mailing Address - Phone:631-255-9831
Mailing Address - Fax:
Practice Address - Street 1:719 LEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5621
Practice Address - Country:US
Practice Address - Phone:631-255-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11029225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist