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Individual

SARAH R. GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13535 NEMOURS PKWY, NEMOURS CHILDRENS HOSPITAL, ORLANDO, FL 32827-7402
(407) 567-4000
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT., ROCKLAND, DE 19732-0191

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
ME108104
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063689644
NPI
01
ME108104
FLORIDA MEDICAL LICENSE
FL
Enumeration date
05/13/2008
Last updated
09/27/2013
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