Provider Demographics
NPI:1770083073
Name:SANBORN, MEGAN (APRN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SANBORN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:DALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 58TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-1326
Mailing Address - Country:US
Mailing Address - Phone:727-822-4300
Mailing Address - Fax:727-456-1399
Practice Address - Street 1:2 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-821-8038
Practice Address - Fax:813-974-0483
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9308456363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3TQM9OtherBLUE CROSS BLUE SHIELD
FL123425600Medicaid
FL9308455OtherCERTIFIED PEDIATRIC NURSE PRACTITIONER