MEDICARE: SARA JANE SENGEL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA3556	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033111323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA JANE SENGEL PA

Provider Business Mailing Address
First Line	:	6300 N WICKHAM RD
Second Line	:	SUITE 101
City	:	MELBOURNE
State	:	FL
Zip	:	32940-2028
Country	:	US
Telephone Number	:	321-253-2169
Fax Number	:	321-253-1720

Provider Business Practice Location Address
First Line	:	6300 N WICKHAM RD
Second Line	:	SUITE 101
City	:	MELBOURNE
State	:	FL
Zip	:	32940-2028
Country	:	US
Telephone Number	:	321-253-2169
Fax Number	:	321-253-1720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/08/2014

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Directions to “ SARA JANE SENGEL PA” Practice Location

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