Individual
SANDRA SUE IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5201 RAYMOND ST, ORLANDO, FL 32803-8208
(407) 629-1599
(407) 599-1414
Mailing address
1704 DAUPHIN LN, ORLANDO, FL 32803-1806
(407) 895-0822
(407) 599-1414
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0001915
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
RN42171-2
FL
Other
Enumeration date
06/30/2006
Last updated
09/11/2025
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