Individual
SANDRA PAYOUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4678 NW 22ND ST, COCONUT CREEK, FL 33063-9201
(954) 536-7670
Mailing address
4678 NW 22ND ST, COCONUT CREEK, FL 33063-9201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9453846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9453846
9453846
FL
Enumeration date
01/12/2021
Last updated
01/12/2021
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