MEDICARE: SARAH WILLARD MD 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	208600000X	Surgery Physician	ME71364	FL

General Provider Information

NPI Number	:	1235363425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH WILLARD MD PA

Provider Business Mailing Address
First Line	:	PO BOX 568906
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32856-8906
Country	:	US
Telephone Number	:	407-425-5587
Fax Number	:	407-426-0567

Provider Business Practice Location Address
First Line	:	1802 BELLEVUE AVE
Second Line	:	SUITE 101
City	:	ORLANDO
State	:	FL
Zip	:	32806-2933
Country	:	US
Telephone Number	:	407-425-5537
Fax Number	:	407-426-0576

Authorized Official
Title or Position	:	MD
Name	:	DR. SARAH CAMP WILLARD
Credential	:	MD
Telephone Number	:	407-425-5587

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/04/2009

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