| Doctor Name: | MS. SANDRA EUGENIA GIBSON |
| NPI Number: | 1487860029 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP80523 |
| Business Practice Address: | 400 N.e.4th Street Ft. Lauderdale, FL - 33301 |
| Business Phone Number: | 9547654159 |
| Business Fax Number: | |
| Mailing Address: | 4700 Washington St Apt 211, HOLLYWOOD |
| State: | FL |
| Postal Code: | 330217659 |
| Phone Number: | 3054950459 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP80523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |