Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | ME 96300 | FL |
NPI | 1407047657 |
---|---|
Provider Name | Dr. Chad Robert Sanborn |
First Address | Coral Gables, FL 33146 |
Second Address | Mangonia Park, FL 33407-2450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001311900 | (05) | FL |