Basic Information
Provider Information
NPI: 1265154744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAGARBARRIA
FirstName: NATALIE
MiddleName: GRACE
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5840 CORPORATE WAY STE 101
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334072040
CountryCode: US
TelephoneNumber: 5614320111
FaxNumber: 5614321075
Practice Location
Address1: 7431 ATLANTIC AVE STE 52
Address2:  
City: DELRAY BEACH
State: FL
PostalCode: 334463506
CountryCode: US
TelephoneNumber: 5614320111
FaxNumber: 5614321075
Other Information
ProviderEnumerationDate: 09/13/2022
LastUpdateDate: 09/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT26870FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home