Individual
MRS. SHARON SANFORD BANASIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2452 MAHAN DR STE 101, TALLAHASSEE, FL 32308-5377
(850) 877-2126
(850) 877-6046
Mailing address
2452 MAHAN DR STE 101, TALLAHASSEE, FL 32308-5377
(850) 877-2126
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9106960
FL
Other
Enumeration date
12/06/2012
Last updated
10/26/2016
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