Individual
MICHAEL ANTHONY SISBARRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3601 HENDRICKS AVENUE, JACKSONVILLE, FL 32207
(904) 396-2666
(904) 396-2698
Mailing address
3601 HENDRICKS AVENUE, JACKSONVILLE, FL 32207
(904) 396-2666
(904) 396-2698
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9074711
PRIVATE HEALTH CARE SYSTE
—
01
—
Z9890
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/17/2007
Last updated
07/08/2007
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