Individual provider Active NPI

Jenny Isabel Sabogal

  • Specialist
  • Oakland Park, FL
National Provider Identifier
1629252135
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA51447 Issued in FL
Practice address
4450 NE 20TH Ave
Oakland Park, FL 33308-5112
Phone
(954) 689-3770
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA51447 FL Primary

Addresses

Primary practice location

4450 NE 20TH Ave
Oakland Park, FL 33308-5112

Mailing address

1109 Pine Dr
Pompano Beach, FL 33060-7414
Phone (954) 689-3770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA51447FLMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1629252135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 PINE DR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607414",
            "telephone_number": "954-689-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 NE 20TH AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333085112",
            "telephone_number": "954-689-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABOGAL",
        "first_name": "JENNY",
        "middle_name": "ISABEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA51447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.