| Doctor Name: | ALEXANDRA A SANBORN |
| NPI Number: | 1063761500 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA9106852 |
| Business Practice Address: | 1361 13th Ave S Ste 270 Credentialing Department Jacksonville Beach, FL - 322503258 |
| Business Phone Number: | 9042417147 |
| Business Fax Number: | 9042415492 |
| Mailing Address: | Po Box 40767, Credentialing Department JACKSONVILLE |
| State: | FL |
| Postal Code: | 322030767 |
| Phone Number: | 9043763707 |
| Fax Number: | 9043915807 |
| NPI Enumeration Date: | 08/30/2012 |
| NPI Last Update Date: | 02/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9106852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |