Provider Demographics
NPI:1629890439
Name:DEBROSSE, SARA-JEAN (PMHNP)
Entity type:Individual
Prefix:MS
First Name:SARA-JEAN
Middle Name:
Last Name:DEBROSSE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 GREENWOOD OAK DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-5153
Mailing Address - Country:US
Mailing Address - Phone:516-532-5903
Mailing Address - Fax:
Practice Address - Street 1:2141 GREENWOOD OAK DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-5153
Practice Address - Country:US
Practice Address - Phone:516-532-5903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2024084279363L00000X
FLAPRN11036252363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner